CEAP is the acronym for the Clinical-EtiologyAnatomy-Pathophysiology, an international standard for classification of limbs affected with chronic venous disease (CVD). Originally developed in 1993 it has undergone three revisions, the most recent published in 2020.
The most important change to the C domain is the introduction of the subscript “r” to denote recurrence and is explicitly stated to relate to recurrent varicose veins and venous ulceration (C2r and C6r). The rationale is to allow distinction of limbs with primary from those with recurrent varicose veins and ulcerations, which have different natural histories. The other change is creating the C4c classification for the presence of corona phlebectatica, which has been demonstrated to be predictive of progression of CVD to skin injury (C4b and C6).
Lurie F, Passman M, Meisner M, et al. The 2020 update of the CEAP classification system and reporting standards. J Vasc Surg Venous Lymphat Disord 2020; 8: 342–352.