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Diagnosing lipodermatosclerosis

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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

History taking

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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Comments

Excellent articel, just right amount of info for professionals & patients. Some ideas of lotions/creams etc to manage skin would be helpful
Posted by: ,
I suffer with this problem in both lower parts of my legs. Hardening of the skin and extremely itchy. I rub in Dermol cream quite regularly, giving very little satisfaction. Any suggestions to relieve the itching and hardening of the skin?
Posted by: ,
Thank you for a very informative and useful article. I have just, today, been diagnosed by St Thomas' hospital, London as suffering from lipordermatosclerosis. I have been trying to get a satisfactory answer to the problems I was suffering but was constantly told by assorted practice GPs that I merely was suffering from bad dry skin!
It seemed to have escaped their notice (or interest) that I was known to suffer venous insufficiency following severe trauma to my legs many many years ago and underwent lower limb fixation with an Ilizarov external fixator in the late 90s. I am also over weight and have diminished mobility due to other medical problems.
The situation has now reached a stage where my left lower leg needs antibiotic treatment. I have also suffered severed ulceration of the right lower leg but it has taken this long to get passed my surgery to receive a good outcome and treatment for the problem.
As I say, a very interesting and helpful article. Thank you
Posted by: ,
Thank you. Very informative.
Posted by: ,
I have similar problem and I need help and the kind of medicine to use
Posted by: ,

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