"Ankle blow out" syndrome for varicose veins
The gaiter areas are the areas where skin changes and venous stasis ulcers are most likely to occur - these areas are where the most prominent perforator veins are likely to be found.
Perforator vein incompetence in these gaiter areas have been shown to increase ambulatory venous pressures above 100 mm Hg (venous hypertension), a phenomenon which has also been referred to "ankle blow-out" syndrome in the gaiter areas.
The combination of incompetent perforator veins and resultant venous hypertension over time causes damage to capillaries in the skin and subcutaneous capillaries, allowing protein rich fluid and red blood cells to escape into the subcutaneous tissue around the ankle.
The effect is that the subcutaneous tissue becomes fibrotic and skin pigmentation results from hemosiderin deposition.