Sixteen years following its last revision, the CEAP classification was updated earlier this year. See the chart below, which outlines the CEAP classification tool timeline.
The changes to the Clinical, or "C" in CEAP is the addition of the subscript "r" to describe recurrence of varicose veins and ulcerations, for example C2r and C6r. The purpose is to distinguish patients who have primary disease versus those who have recurring disease as these have different natural histories. The other primary change is the addition of the C4c category, including corona phlebectatica as a standalone choice. See revised table below from the Journal of Vascular Surgery (JVS-VL), including changes mentioned here.
J Vasc Surg Venous Lymphat Disord. 2020 May; 8(3):342-352. doi: 10.1016/j.jvsv.2019.12.075.Epub 2020 Feb 27.
Khilnani NM, Davies AH. CEAP: A review of the 2020 revision. Phlebology. October 2020. doi:10.1177/0268355520961239