Lipodermatosclerosis

Lipodermatosclerosis is a skin and connective tissue disease characterized by inflammation of the subcutaneous fat layer, often associated with chronic venous insufficiency. It is also known as sclerosing panniculitis or hypodermitis sclerodermiformis.

Pathophysiology

Lipodermatosclerosis is thought to result from long-standing venous hypertension and venous stasis, which lead to increased pressure in the capillaries and subsequent leakage of fibrinogen and other proteins into the surrounding tissue. This process causes inflammation and fibrosis of the skin and subcutaneous tissues.

Clinical Presentation

Patients with lipodermatosclerosis typically present with induration, hyperpigmentation, and pain in the lower legs. The skin may appear red, brown, or purple, and the affected area is often tender to touch. In chronic cases, the skin may become hardened and resemble an inverted champagne bottle.

Diagnosis

Diagnosis of lipodermatosclerosis is primarily clinical, based on the characteristic appearance of the skin and the presence of underlying venous disease. Doppler ultrasound may be used to assess venous insufficiency and rule out other conditions such as deep vein thrombosis.

Treatment

Treatment of lipodermatosclerosis focuses on managing the underlying venous insufficiency and alleviating symptoms. This may include:

• Compression therapy to reduce venous pressure and improve circulation.
• Topical corticosteroids to reduce inflammation.
• Pentoxifylline to improve blood flow.
• Surgery or endovenous ablation to address venous reflux.

Prognosis

The prognosis for lipodermatosclerosis varies depending on the severity of the underlying venous disease and the effectiveness of treatment. Early intervention can prevent progression and improve symptoms, but chronic cases may lead to persistent skin changes and ulceration.

Related Pages

• Chronic venous insufficiency
• Venous ulcer
• Varicose veins
• Panniculitis

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