9
Table 5. Revised Venous Clinical Severity Scoring (VCSS)
System
None: 0 Mild: 1 Moderate: 2 Severe: 3
Pain or other
discomfort (i.e.,
aching, heaviness,
fatigue, soreness,
burning )
(Presumes venous
origin)
Occasional
pain or other
discomfort
(i.e., not
restricting
regular daily
activities)
Daily pain
or other
discomfort
(i.e.,
interfering
with but not
preventing
regular daily
activities)
Daily pain or
discomfort
(i.e., limits
most
regular daily
activities)
Varicose veins:
"Varicose" veins
must be ≥3 mm in
diameter to qualify
in the standing
position
Few:
scattered
(i.e., isolated
branch
varicosities or
clusters)
Also includes
corona
phlebectatica
(ankle f lare)
Confined to
calf or thigh
Involves calf
and thigh
Venous edema Limited to
foot and ankle
area
Extends above
ankle but
below knee
Extends to
knee and
above
Skin pigmentation:
(Presumes venous
origin) Does not
include focal
pigmentation over
varicose veins or
pigmentation due
to other chronic
diseases
None or focal Limited to
perimalleolar
area
Diffuse over
lower third
of calf
Wider
distribution
above lower
third of calf
Inflammation:
More than just
recent pigmentation
(i.e., erythema,
cellulitis, venous
eczema, dermatitis)
Limited to
perimalleolar
area
Diffuse over
lower third
of calf
Wider
distribution
above lower
third of calf
