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Lipodermatosclerosis in patients with diffuse connective tissue diseases.

Fernanda Dias Gonzalez1, Fernanda Pedreira Magalhães, Alice Pontes Vilas Boas Freitas

  • 1Núcleo de Reumatologia do Hospital Santa Izabel, Escola Bahiana de Medicina e Saúde Pública-Salvador/ Bahia, Brazil.

European Journal of Internal Medicine
|June 10, 2006
PubMed
Summary

Lipodermatosclerosis (LDS) is a painful leg condition. This study highlights three cases of LDS in patients with diffuse connective tissue diseases (DCTD), emphasizing its recognition for appropriate patient management.

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Area of Science:

  • Dermatology
  • Rheumatology
  • Internal Medicine

Background:

  • Lipodermatosclerosis (LDS) presents as hardened, painful, hyperchromic plaques on the legs.
  • LDS is often associated with venous insufficiency, but its pathogenesis remains unclear.
  • Skin thickening in LDS can mimic scleroderma, posing diagnostic challenges.

Purpose of the Study:

  • To describe the occurrence of lipodermatosclerosis in patients with diffuse connective tissue diseases (DCTD).
  • To underscore the importance of recognizing LDS in DCTD patients.
  • To prevent potential adverse effects from misdirected treatments.

Main Methods:

  • Case series describing three patients with diagnosed diffuse connective tissue diseases.
  • Detailed clinical presentation of lipodermatosclerosis in each patient.

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  • Review of patient histories including associated conditions and previous diagnoses.
  • Main Results:

    • Three patients with distinct DCTD (systemic lupus erythematosus with antiphospholipid syndrome, overlapping DCTD, CREST syndrome with primary biliary cirrhosis) developed lipodermatosclerosis.
    • The clinical presentation of LDS was consistent across these diverse DCTD cases.
    • The skin changes in LDS were noted to be similar to those seen in scleroderma.

    Conclusions:

    • Lipodermatosclerosis can manifest in patients with various diffuse connective tissue diseases.
    • Early and accurate identification of LDS in DCTD patients is crucial for appropriate management.
    • Recognizing LDS can help avoid the potentially harmful use of medications like penicillamine and immunosuppressants.