Lipodermatosclerosis

Key Points
Type of panniculitis affecting the lower legs
Exact cause is unknown, but may be related to venous hypertension or incompetence
Initially consists of tender, painful, inflamed areas above the ankle, which may be red and/or scaly, with minor skin thickening

Lipodermatosclerosis is a type of panniculitis (inflammation of subcutaneous fat) which affects the lower leg. In its acute, or initial phase, the condition consists of tender, painful and inflamed areas above the ankle, which may be red in color and/or scaly, and are accompanied by minor thickening of the skin in the affected areas. As the condition enters the chronic phase, affected persons will experience continued pain, hardening of the skin, further thickening in affected areas, redness, swelling, darkening of the skin, small white Scars, an increase of fluid in the leg, varicose veins, and even ulcers on the leg.

The exact cause of lipodermatosclerosis is unknown, but it may be related to venous incompentence/hypertension and/or obesity, though it may appear before venous issues are present. The condition typically presents during middle age.

Diagnosis
Key Points
Diagnosis based on characteristic appearance of the affected area
Biopsy and other tests are typically not required, though imaging tests may be performed to help determine the course of treatment.

Lipodermatosclerosis is diagnosed based on the characteristic appearance of the affected area. Biopsy and other testing is typically not required, though health care professionals may recommend imaging tests to assist in determining the course of treatment.

Treatment
Primary treatment is management of venous issues
*Goal of treatment is to manage and/or reduce symptoms

Treatment of lipdermatosclerosis is built around the management of venous issues, with the goal of that treatment being to manage and/or reduce the symptoms of the disorder. This is primarily accomplished with compression therapy to the lower legs. Other therapies include vein surgery, ultrasound therapy, weight reduction, fibrinolytic agents, pentoxyfylline, clobetasol propionate, intralesional triamcinolone, and capsaisin.