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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.
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.
