ABSTRACT
Lipodermatosclerosis (LDS) is a serious skin change associated with the progression of chronic venous insufficiency (CVI) of the lower extremities, and can be clinically divided into acute phase, subacute phase and chronic phase. The disease is common in middle-aged women, prone to occur in the lower leg 1/3, clinical manifestations of the skin flake erythema, induration, pigmentation, skin rough and thickening. The patients often suffer from secondary infection after scratching due to pruritus. The severe ones can form refractory ulcer or even cause skin necrosis, and may be canceration. At present, domestic reports on LDS are less, the clinical manifestations, etiology, pathogenesis and treatment of the LDS are reviewed in present paper, in order to strengthen the understanding of LDS and provide the evidence for clinical diagnosis and treatment of LDS.
ABSTRACT
A lipodermatoesclerose é uma paniculite que se caracteriza por endurecimento e hiperpigmentação da pele envolvendo as panturrilhas, com a aparência de "garrafa de champanhe invertida". Muitas abordagens terapêuticas têm sido recomendadas, mas o uso de oxandrolona para essa finalidade foi pouco estudado até o momento. Relatamos um caso de lipodermatoesclerose aguda em uma mulher de 61 anos, com história prévia de tratamento cirúrgico para insuficiência venosa de membros inferiores. A paciente apresentava edema e lesões dolorosas e eritematosas com infiltração difusa, que acometiam principalmente a face posterior da panturrilha esquerda. Foi tratada inicialmente com estanozolol e pentoxifilina, com boa resposta. Devido à indisponibilidade do estanozolol, iniciou-se o uso de oxandrolona. Esse tratamento foi bem tolerado, resultando em redução significativa do edema, do eritema e da infiltração presentes nos membros inferiores, além de alívio da dor. A oxandrolona pode representar uma opção útil e segura no tratamento da lipodermatoesclerose aguda
Lipodermatosclerosis is a panniculitis characterized by hardening and hyperpigmentation of the skin involving the calves with an "inverted champagne bottle" appearance. Many therapeutic approaches have been recommended, but the use of oxandrolone for this purpose has been studied very little to date. We report a case of acute lipodermatosclerosis in a 61-year-old woman with a previous history of surgical treatment for venous insufficiency of the lower limbs. The patient presented with edema and painful, erythematous lesions with diffuse infiltration, mainly affecting the posterior aspect of the left calf. She was initially treated with stanozolol and pentoxifylline, with good response. Due to unavailability of stanozolol, she was put on oxandrolone. This treatment was well tolerated, reduced the intensity of edema, erythema, and infiltration in the lower limbs, effectively leading to pain relief. Oxandrolone may be a useful and safe treatment for patients with acute lipodermatosclerosis
Subject(s)
Oxandrolone/therapeutic use , Panniculitis , Pentoxifylline , Stanozolol , Venous Insufficiency/therapy , Lower ExtremityABSTRACT
Sclerosing panniculitis refers to indurated erythema with hyperpigmented scleroderma-like hardening on the medial lower third of the legs. It has been called indurated cellulitis, chronic cellulitis, hypodermitis sclerodermiformis or lipodermatosclerosis. It has been suggested that sclerosing panniculitis is associated with venous insufficiency. The treatment of sclerosing panniculitis is very difficult. Stanozolol is valuable in treating intractable sclerosing panniculitis, giving relief of pain, reducing induration, inflammation, tenderness and pigmentation by its fibrinolytic activity. We report a case of sclerosing panniculitis, clinically improved by stanozolol.
ABSTRACT
Antithrombin is one of the main endogenous anticoagulants. Antithrombin deficiency may result from hereditary or acquired factors. Inherited antithrombin deficiency is an uncommon autosomal disorder associated with a tendency to venous thromboembolism. Stasis dermatitis occurs as a result of venous stasis caused by venous incompetence or deep vein thrombosis. Furthermore, lipodermatosclerosis that refers to the skin induration and hyperpigmentation of the legs, often occurs in patients who have venous insufficiency. We report a case of stasis dermatitis, complicated by lipodermatosclerosis on both legs of a patient with hereditary antithrombin III deficiency.