Lipodermatosclerosis

Excerpt

Lipodermatosclerosis, also referred to as sclerosing panniculitis or hypodermitis sclerodermaformis, is a persistent inflammatory disorder characterized by the development of subcutaneous fibrosis and induration of the skin of the lower extremities. Huriez et al published the first account of lipodermatosclerosis in 1955, describing the findings of this condition. The pathophysiologic mechanisms of this disease process are not well understood; several pathogenic mechanisms have been proposed. While existing evidence strongly supports the association between lipodermatosclerosis and venous insufficiency, irregularities in fibrinolysis have also been implicated. The diffusion of capillary contents, including fibrinogen and other inflammatory mediators, into the dermis and subcutis, is thought to occur due to increased pressure within the venous circulation of the lower extremities.

Progressive fibrosing panniculitis ultimately leads to the classic appearance of lipodermatosclerosis, characterized by a lower extremity exhibiting an inverted champagne bottle shape. This classic description is representative of advanced-stage lipodermatosclerosis; the clinical presentation of this condition can vary significantly depending on the phase of the disease. The diagnosis is usually made clinically, relying solely upon hallmark features. In cases where the diagnosis is uncertain, histological examination can provide confirmation.