lipodermatoskleroosia

Lipodermatosclerosis, also known as lipodermatoskleroosia, is a form of chronic venous insufficiency–related panniculitis in which the subcutaneous fat of the lower legs undergoes inflammatory and fibrosing changes. The condition reflects sustained venous hypertension and is part of the spectrum of stasis dermatoses.

It most commonly involves the medial aspects of the ankles and lower legs. In the acute inflammatory phase, patients may have erythema, warmth, pain, and edema. In the chronic phase, the skin becomes thickened, hyperpigmented, indurated, and fibrotic. A characteristic tapering of the leg just above the ankle—often described as an inverted champagne bottle shape—can occur and contribute to a constrained appearance of the lower leg.

Complications include venous ulcers, recurrent cellulitis, and persistent edema. The diagnosis is clinical and supported by duplex ultrasonography demonstrating venous insufficiency or reflux. Skin biopsy is rarely required but, when performed, may show sclerosis of subcutaneous fat with septal or lobular panniculitis.

Management centers on improving venous return and skin care. Core measures include leg elevation and compression therapy, proper wound care for ulcers, and treatment of infection. Addressing underlying venous disease with procedures such as endovenous ablation or surgery for incompetent varicose veins or perforators may be indicated. Adjuncts such as pentoxifylline or micronized flavonoids can be considered, and lifestyle measures like smoking cessation and weight control are advised. The condition tends to be chronic and may stabilize with appropriate management, though recurrence or progression of ulcers can occur.