Phlebology is an important field of Dermatology and Venereology. Dermatology made fundamental contributions to our understanding of morphology and pathophysiology of chronic venous insufficiency. Milestones in treatment, such as the principles of compression therapy, sclerotherapy, ambulatory phlebectomy, endovenous thermoablation, tumescent local anesthesia, and the «shave therapy» of chronic leg ulcers have been pioneered by dermatologists.
For several reasons, teaching and clinical practice in «dermatologic» phlebology have declined through the last 20 years. The outstanding importance of immunologic research, the rise of dermatolooncology and dermatosurgery in the wake of the skin cancer epidemic, and the popularity of antiaging shifted dermatology away from phlebology. Duplex sonography is the diagnostic working horse of phlebology. This technique requires specialized training that is not simple to obtain for dermatology residents.
On the other hand, interventional phlebology has partly turned away from vascular surgery, as more non-surgical, effective modalities are now available. Under this aspect, modern phlebology may become attractive again for young dermatologists.
Phlebology is interdisciplinary, and it contains both conservative and interventional elements. Therefore, phlebology cannot be exclusively learnt from text books. It requires practical training over several levels of experience. Courses are suitable for giving a first insight into practical aspects of phlebology, in the «wet lab» setting, without the responsibility for «real» patients. During such courses, residents get an opportunity to interact with the teachers, sometimes opening a door for a later consolidation of the acquired skills as visiting physician. This interaction between trainees and teachers is one of the particular benefits of intensivecourses.
We would be more than happy, if the present «Phlebology – Dermatology» course achieves this goal. Those who have never tried cannot tell if it works. Let’s do the course and see if we manage to light the fire of phlebology in dermatology.
Kind regards
Jürg Hafner
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