Lipodermatosclerosis is a disorder that targets the skin just above a person’s ankle who has a long history of venous disease that results in chronic venous insufficiency. Lipodermatosclerosis refers to scarring of both the skin and fat. It’s a gradual process that happens slowly over the course of many years. The disorder affects the skin area just above the person’s ankle, typically on the surface inside. In time, the skin starts to become tight, smooth, and brown in color as well as painful. Although researchers know the root cause of Lipodermatosclerosis, the exact mechanism of the disorder isn’t yet fully understood.
Lipodermatosclerosis is primarily caused by too much venous pressure within the lower legs subcutaneous veins. This unusually high pressure is a result of two main factors, which include:
- Standing upright or walking for long periods of time
- An unproductive calf muscle pump
Unless the fundamental cause of Lipodermatosclerosis is properly treated, the individual remains at a higher risk of developing a potentially chronic and painful venous leg ulcer. However, once Lipodermatosclerosis manifests, the skin is already irreversibly damaged. At this point, doctors hope to slow down the progression of Lipodermatosclerosis in order to prevent a painful leg ulcer. A Lipodermatosclerosis patient needs to be referred to a vascular-based surgical clinic like South Texas Vein Institute to receive a full evaluation of their venous system.
The primary Lipodermatosclerosis treatment is using compression socks. These special socks are designed to put ample pressure on the skin near the ankle while exerting less pressure on the patient’s calf. The socks work to offset the excess pressure within the veins, which is a direct result of walking and/or standing.
How to Effectively Manage Lipodermatosclerosis
The most vital aspect of good Lipodermatosclerosis management is to use compression therapy in order to address venous stasis, which may include the following:
- Ultrasound therapy
- Vein surgery, Sclerotherapy, or endovenous laser ablation
- Weight reduction
- Capsaicin, used to diminish pain
- Pentoxifylline to enhance blood flow
- Fibrinolytic agents including stanozolol
- Ultra potent topical steroid (Clobetasol Propionate) or intralesional
Lipodermatosclerosis is typically diagnosed in a clinic. Dermatopathology illustrates histological changes that primarily have an effect on the fat and is based on the phase of the disease.
- Early skin lesions reveal an infiltration of white blood cells (lymphocytes) along with spots of tissue death within the patient’s fibrous tissue separating the septa (fat).
- Intermediate skin lesions reveal a combination of new fibrous tissue in the fat and infiltration of white cells.
- Late skin lesions illustrate obvious fibrosis in the septa with absent or decreased inflammatory cells. Marked changes in the dermis involve a combination of inflammatory cell infiltration, atrophy, increased fibrous cells as well as twisted thick-walled veins.
The stages of histology correspond well with the two phases seen clinically. Usually, blood tests aren’t required regarding Lipodermatosclerosis, although coagulation is often tested. Magnetic resonance imaging (MRI) and ultrasound technology can be used to determine the extent of Lipodermatosclerosis and to also figure out if there’s a need for vascular surgery in general.
At South Texas Vein Institute, our doctors will work with you to offer a diagnosis and treatment options for any vein conditions or disorders you may have. Contact South Texas Vein Institute today to schedule your consultation.