如何分辨正常明顯的血管還是靜脈曲張? How to differentiate apparent normal veins and varicose veins?

在門診經常會碰到病人，誤把明顯的血管當成靜脈曲張，有些是第一次來諮詢，有些則是治療後，原本的靜脈曲張消失了，就開始注意一些正常的小血管。正常血管常被誤會的有紅色細血絲、綠色微凸靜脈、足背靜脈。

Some apparent veins of our legs are frequently misunderstood as abnormal spider veins or varicose veins. The most common ones are tiny thread veins, greenish bulging veins, dorsal foot veins, ankle saphenous veins, etc. 

一、紅色細血絲 (Tiny thread vein)

又稱微細血管擴張(圖一)，無規則散在性分布，直徑0.1-0.2mm，數量眾多，分布腿部各處，尤以小腿下半部與外側最多。這類的血管是原本就存在皮膚的，受到食物(酒)、藥物(血管擴張劑、避孕藥)、女性荷爾蒙、久站、氣溫(熱天)、情緒等因素影響，造成血管擴張。這類血管不用治療，因為消除以後可能會從它處再長新的出來。真正的蜘蛛網型靜脈曲張，在外觀上還是跟正常的紅色系血絲不同。它們通常顯得較扭曲，且有些部分顏色較深(圖二)。

1. Tiny thread veins

These numerous veins diffusely distribute over the legs with diameters ranging between 0.1mm-0.2mm (Figure 1). These veins are the ordinary veins in our skin, most in the epidermal layer. They can be dilated and become apparent under the influence of food (alcohol), drug (vasodilator, contraceptives), female hormone, standing for a long time, high temperature (hot weather), emotion. These veins do not need treatment. Forceful clearance of them may stimulate growth of other new vessels. With detailed observation, the real abnormal spider veins look different from them. The spider veins appear tortuous with deep color and tend to be in clusters (Figure 2).

全文 Original Article: http://eadwinechen.blogspot.tw/2017/10/blog-post_5.html