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©2013 UpToDate ® Print Email CEAP classification for chronic venous disorders Clinical classification C 0 No visible or palpable signs of venous disease C 1 Telangiectasias, reticular veins, malleolar flares C 2 Varicose veins C 3 Edema without skin changes C 4 Skin changes ascribed to venous disease (eg, pigmentation, venous eczema, lipodermatosclerosis) C 4a Pigmentation or eczema C 4b Lipodermatosclerosis or atrophie blanche C 5 Skin changes as defined above with healed ulceration C 6 Skin changes as defined above with active ulceration S Symptomatic, including ache, pain, tightness, skin irritation, heaviness, and muscle cramps, and other complaints attributable to venous dysfunction A Asymptomatic Etiologic classification Ec Congenital Ep Primary Es Secondary (postthrombotic) En No venous cause identified Anatomic classification As Superficial veins Ap Perforator veins Ad Deep veins An No venous location identified Pathophysiologic classification Pr Reflux Po Obstruction Pr,o Reflux and obstruction Pn No venous pathophysiology identifiable Limbs in higher categories have more severe signs of chronic venous disease and may have some or all of the findings defining a less severe clinical category. Each limb is further characterized as asymptomatic (A), for example, C0-6,A, or symptomatic (S), for example, C0-6,S. Symptoms that may be associated with telangiectatic, reticular, or varicose veins include lower extremity aching, pain, and skin irritation. Therapy may alter the clinical category of chronic venous disease. Limbs should therefore be reclassified after any form of medical or surgical treatment. Data from: Eklof B, Rutherford R, Bergan J, et al. Revision of the CEAP classification for chronic venous disorders: Consensus statement. J Vasc Surg 2004; 40:1248.