| PAIN or other discomfort (ie, aching, heaviness, fatigue, soreness, burning); presumes venous origin |
| None: 0 |
| None |
| Mild: 1 |
| Occasional pain or other discomfort (ie, not restricting regular daily activity) |
| Moderate: 2 |
| Daily pain or other discomfort (ie, interfering with but not preventing regular daily activities) |
| Severe: 3 |
| Daily pain or discomfort (ie, limits most regular daily activities) |
VARICOSE VEINS:
“Varicose” veins must be ≥3 mm in diameter to qualify in the standing position |
| None: 0 |
| None |
| Mild: 1 |
| Few: scattered (ie, isolated branch varicosities or clusters); also includes corona phlebectatica (ankle flare) |
| Moderate: 2 |
| Confined to calf or thigh |
| Severe: 3 |
| Involves calf and thigh |
VENOUS EDEMA:
Presumes venous origin |
| None: 0 |
| None |
| Mild: 1 |
| Few: scattered (ie, isolated branch varicosities or clusters); also includes corona phlebectatica (ankle flare) |
| Moderate: 2 |
| Confined to calf or thigh |
| Severe: 3 |
| Involves calf and thigh |
SKIN PIGMENTATION:
Presumes venous origin; does not include focal pigmentation over varicose veins or pigmentation due to other chronic diseases (ie, vasculitis purpura) |
| None: 0 |
| None |
| Mild: 1 |
| Limited to foot and ankle area |
| Moderate: 2 |
| Extends above ankle but below knee |
| Severe: 3 |
| Extends to knee and above |
INFLAMMATION:
More than just recent pigmentation (ie, erythema, cellulitis, venous eczema, dermatitis) |
| None: 0 |
| None or focal |
| Mild: 1 |
| Limited to perimalleolar area |
| Moderate: 2 |
| Diffuse over lower third of calf |
| Severe: 3 |
| Wider distribution above lower third of calf |
INDURATION:
Presumes venous origin of secondary skin and subcutaneous changes (ie, chronic edema with fibrosis, hypodermitis); includes white atrophy and lipodermatosclerosis |
| None: 0 |
| None |
| Mild: 1 |
| Limited to perimalleolar area |
| Moderate: 2 |
| Diffuse over lower third of calf |
| Severe: 3 |
| Wider distribution above lower third of calf |
ACTIVE ULCERS:
Active ulcer duration (longest active) |
None: 0
No active ulcers |
| NA |
Mild: 1
1 active ulcer |
| <3 mo |
Moderate: 2
2 active ulcers |
| >3 mo but <1 y |
Severe: 3
≥3 active ulcers |
| Not healed for >1 y |
ACTIVE ULCERS:
Active ulcer size (largest active) |
None: 0
No active ulcers |
| NA |
Mild: 1
1 active ulcer |
| Diameter <2 cm |
Moderate: 2
2 active ulcers |
| Diameter 2-6 cm |
Severe: 3
≥3 active ulcers |
| Diameter >6 cm |
| Use of compression therapy |
| None: 0 |
| Not used |
| Occasional: 1 |
| Intermittent use of stockings |
| Frequent: 2 |
| Wears stockings most days |
| Always: 3 |
| Full compliance: stockings |
Adapted from Vasquez et al. Used with permission.