Laboratory Studies

The laboratory evaluation for factor-related hypercoagulability conditions includes measurement and evaluation of the following:

Complete blood cell counts, prothrombin time, activated partial thromboplastin time, and serum chemistry values
Protein C and APC resistance (factor V Leiden testing if abnormal)
Protein S level
Antithrombin level
Antiphospholipid antibodies panel (lupus anticoagulant, anticardiolipin, anti-beta2-glycoprotein I)
Homocysteine level

See Pathophysiology.

Imaging Studies

Venous duplex ultrasonography, which is mandatory, helps in diagnosing the thrombosis in the vein and details its extent.

Venography, which is rarely necessary, may be used to define the extent and propagation of the thrombosis.

If PE is suspected, appropriate tests such as chest radiography, helical computed tomography scanning, ventilation-perfusion lung scintigraphy, and/or pulmonary venography may be necessary.

Procedures

If an occult malignancy is suspected, a thorough workup should be performed. A complete medical workup is required in young adults who have thrombophlebitis but no predisposing factors because an occult malignancy is possible.

Histologic Findings

It is important to differentiate superficial thrombophlebitis from polyarteritis nodosa in biopsy specimens. Attention to the pattern of the muscularis (bundled in veins, nonbundled wreath in artery) and the elastic pattern (surrounding bundles in veins) can help to distinguish the two.^[117]

Treatment & Management

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Media Gallery

Superficial thrombophlebitis. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/assets/Uploads/vascular/thrombophlebitis.jpg).
Deep venous thrombosis.

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Author

Padma Chitnavis, MD Resident Physician, Department of Dermatology, Howard University Hospital and Veterans Affairs Medical Center

Disclosure: Nothing to disclose.

Coauthor(s)

Mary Piazza Maiberger, MD Assistant Professor of Dermatology, Howard University College of Medicine; Assistant Clinical Professor of Dermatology, George Washington University School of Medicine and Health Sciences; Chief of Dermatology and Residency Program Site Director, Washington DC VA Medical Center

Mary Piazza Maiberger, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Washington DC Dermatological Society, Women's Dermatologic Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Julia R Nunley, MD Professor, Department of Dermatology, Virginia Commonwealth University Medical Center

Julia R Nunley, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, American Society of Nephrology, International Society of Nephrology, Medical Dermatology Society, Medical Society of Virginia, National Kidney Foundation, Phi Beta Kappa, Women's Dermatologic Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: American Board of Dermatology<br/>Author for: Up-to-date.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Zoltan Trizna, MD, PhD Private Practice

Zoltan Trizna, MD, PhD is a member of the following medical societies: Texas Medical Association

Disclosure: Nothing to disclose.

Mitchel P Goldman, MD Voluntary Clinical Professor of Dermatology, University of California, San Diego, Medical Center; Dermatologist, West Dermatology and Cosmetic Laser Dermatology

Mitchel P Goldman, MD is a member of the following medical societies: Aerospace Medical Association, American Academy of Cosmetic Surgery, American Academy of Dermatology, American College of Phlebology, American Medical Association, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, American Society of Lipo-Suction Surgery, California Medical Association, Dermatology Foundation, Phi Beta Kappa, San Diego County Medical Society

Disclosure: Nothing to disclose.

Carrie L Kovarik, MD Assistant Professor of Dermatology, Dermatopathology, and Infectious Diseases, University of Pennsylvania School of Medicine

Carrie L Kovarik, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Melanie D Palm, MD, MBA, FAAD Director, Art of Skin MD; Assistant Volunteer Clinical Professor, University of California, San Diego, School of Medicine; Affiliate Physician, Scripps Encinitas Memorial Hospital

Melanie D Palm, MD, MBA, FAAD is a member of the following medical societies: American Academy of Cosmetic Surgery, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, Women's Dermatologic Society

Disclosure: Nothing to disclose.

Thrombophlebitis Workup

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

References

Tables

Contributor Information and Disclosures

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