Lipodermatosclerosis is a progressive fibrotic process of the dermis and subcutaneous fat. It is associated with chronic venous insufficiency.1
Lipodermatosclerosis is diagnosed based on the history and clinical examination.2
It is important to establish if there is any history of previous skin problems and relevant medical history, such as thrombosis, ulceration of the lower leg, lower leg injury, phlebitis or diabetes. Other causes of peripheral oedema, such as heart failure, nephrotic syndrome and liver disease, may be relevant. A family history of varicose veins may increase the risk of chronic venous insufficiency.3 The appearance of the patient's legs and symptoms may have a significant effect on quality of life.
Possible differential diagnoses include allergic contact dermatitis and cellulitis. Therefore, it is helpful to establish how any skin changes have evolved and how the lower legs have changed in appearance. For example, ask the patient whether she has noticed any dilated veins or skin irritation or dryness. It is important to ask whether the leg is itchy and whether there are any relieving or exacerbating factors.
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