“Think ‘lymphologically’”: When looking at the foot edges (Corona phlebectatica as CVI sign), also check the Bisgaard’s backdrop (most sensitive sign of lymphedema on the distal lower leg and foot)! There are a number of dynamic physiological factors that contribute to a chronic edema. The topographic basic structure on the legs includes external trunk veins, internal guiding veins, and connecting perforator veins. They serve the regular centripetal blood transport against gravity with the help of the leg muscles. In chronic venous insufficiency, the venous congestion leads to a venous pressure increase with edema formation (“Phleboedema”) and tissue changes to the skin and subcutis, even to ultimate skin ulcers. The term “phlebolymphedema” can be used in a descriptive manner if the clinical signs of lymphedema join those of chronic venous insufficiency. Chronic venous hypertension induces an increased microvascular fluid filtration, which overwhelms the lymphatic drainage. It is therefore a mixed picture of chronic venous insufficiency and lymphatic insufficiency.