The CEAP (Clinical, Etiological, Anatomical, Pathophysiology) classification is a standardized system used to describe chronic venous disorders. It consists of four main components:
Clinical classification (C)-
C0: No visible or palpable signs of venous disease
C1: Telangectasia / Reticular vein (Spider vein)
C2: Varicose vein (≥3 mm in diameter)
C3: Edema (swelling) without skin changes
C4- Skin changes due to venous disease
C4a: Eczema / Pigmentation
C4b: Lipo dermato sclerosis (LDS) / Atrophie blanche
C4c: Corona phlebectatica (added in the 2020 revision)
C5: Healed venous ulcer
C6: Active venous ulcer
Each clinical class is further characterised depending upon whether the patient is symptomatic (S) or asymptomatic (A).
Etiological classification (E)-
Ec: Congenital
Ep: Primary
Es: Secondary (post-thrombotic)
En: No venous etiology identified
Anatomical classification (A)-
As: Superficial veins
Ap: Perforator veins
Ad: Deep veins
An: No venous location identified
Pathophysiological classification (P)-
Pr: Reflux
Po: Obstruction
Pr,o: Both reflux and obstruction
Pn: No identifiable venous pathophysiology