Lipodermatosclerosis refers to inflammation and scarring of the subcutaneous fat caused by chronic varicose veins or venous disease. It tends to affect the lower calf.
In abnormal veins, the wall stretches so that the one way valves no longer meet. Blood flows down the leg towards the ankle, instead of forwards up the leg and to the heart. This backlog of blood causes increased pressure in the veins and they begin to leak. Fluid and cells making up the blood are forced out into the surrounding tissues.
Lipodermatosclerosis involves processes of inflammation caused by white blood cell leakage, and processes of tissue death and fibrosis. The calf characteristically develops the appearance of an upside down champagne bottle. The tissues in the gaiter region become hard and woody. The area may be susceptible to further deterioration in skin quality, break down and formation of venous ulcers.
Treatment aims to close these veins to prevent ongoing venous congestion and leakage.
Signs and Symptoms
- Inflammation and scarring of subcutaneous fat.
- Leg swelling.
- Moderate redness.
- Increased pigmentation.
- Hardening and thickening of skin.
- Atrophe blanche (area of white scarring).
- Change in calf appearance.
- Venous ulcers.
- Physical exam.