Lipodermatoskleroosin

Lipodermatoskleroosin, more commonly known as lipodermatosclerosis, is a chronic inflammatory and fibrosing condition of the skin and subcutaneous tissue of the lower legs. It is most closely associated with chronic venous insufficiency and venous hypertension, which drive inflammation and subsequent tissue fibrosis.

Clinically, lipodermatosclerosis typically affects the medial aspect of the legs and presents with induration, tenderness, and skin color changes that range from erythema to brownish hyperpigmentation. The affected skin may feel thickened or rigid, and the leg can appear swollen. In advanced stages, the condition can create a characteristic “inverted bottle” appearance of the leg and may be complicated by ulceration or stasis dermatitis. Symptoms may include burning or itching, and episodes of itching or pain can occur, especially with standing or activity.

Pathophysiology involves venous hypertension leading to leakage of serum proteins and inflammatory cells into the dermis and subcutaneous tissue, triggering adipocyte necrosis, inflammation, and progressive fibrosis. Risk factors include obesity, female sex, age, prolonged standing, and long-standing venous disease.

Diagnosis is primarily clinical, supported by evaluation for underlying venous insufficiency. Doppler ultrasound or other venous imaging helps define reflux and plan treatment. Skin biopsy is rarely required.

Management focuses on addressing venous hypertension and inflammation. Core measures include compression therapy, leg elevation, weight management, and treatment of venous insufficiency (e.g., leg ulcers or varicose veins). Wound care for ulcers and infection control are essential when present. With adequate management of venous disease, symptoms can improve, though the condition can be chronic and prone to recurrence.