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Lipodermatosclerosis: a clinicopathological study of 25 cases.

Sarah N Walsh¹, Daniel J Santa Cruz

¹Cutaneous Pathology, WCP Laboratories Inc., St Louis, Missouri 63043, USA. sarahnwalsh@aol.com

Journal of the American Academy of Dermatology

|May 15, 2010

Summary

Histologic examination reveals characteristic changes diagnostic of lipodermatosclerosis, primarily in the subcutaneous tissue. Key findings include adipose changes and unique elastic fiber accumulation, aiding in diagnosis.

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Area of Science:

Dermatopathology
Histology
Fibrosing conditions

Background:

Lipodermatosclerosis is a chronic fibrosing condition affecting the lower legs.
It classically presents in Caucasian women in their 60s.

Purpose of the Study:

To define the spectrum of histologic findings in lipodermatosclerosis.
To identify characteristic histopathological features for diagnosis.

Main Methods:

Prospective collection of 25 lipodermatosclerosis cases.
Histologic staining with hematoxylin-eosin, von Kossa, and Verhoeff-van Gieson.

Main Results:

Histologic findings predominantly in subcutaneous tissue: adipose changes (pseudocysts, necrotic adipocytes, lipogranulomas) and lipomembranous changes.
Accumulation of basophilic elastic fibers in septa, resembling pseudoxanthoma elasticum, present in all cases.
Medium vessel calcification observed in 13 cases; minimal inflammation noted.

Conclusions:

The described constellation of histologic changes is diagnostic of lipodermatosclerosis.
Pseudoxanthoma elasticum-like changes are a helpful diagnostic clue.