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Revisiting Heinz-Lippman disease as a complication of chronic venous insufficiency
Alisha Oropallo1,2,3, Amanda Beneat3, Amit Rao3
1Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.
Insights
Heinz-Lippmann disease, a rare complication of chronic venous insufficiency, involves bone formation near wounds. This underreported condition may prolong healing of venous leg ulcers, even without prior trauma.
Area of Science:
- Vascular Medicine
- Orthopedics
- Dermatology
Background:
- Chronic venous insufficiency (CVI) is a prevalent condition often linked to varicose veins.
- Venous leg ulcers are a common manifestation of CVI.
- Heterotopic ossification, the formation of bone in non-skeletal tissue, is typically associated with trauma.
Observation:
- Heinz-Lippmann disease, characterized by heterotopic ossification near wounds, is a potentially underreported complication of CVI.
- This study presents three cases of CVI patients without trauma history who developed subcutaneous calcifications consistent with Heinz-Lippmann disease.
- Osteomyelitis was diagnosed in two of the three patients.
Findings:
- Subcutaneous calcifications indicative of Heinz-Lippmann disease can occur in chronic venous insufficiency patients without a history of trauma.
- Physical examination and diagnostic imaging are crucial for diagnosing this condition.
- Biopsy may be necessary to confirm the diagnosis and rule out osteomyelitis.
Implications:
- Recognizing Heinz-Lippmann disease is vital for managing chronic venous insufficiency and venous leg ulcers.
- Early diagnosis and appropriate intervention, including ruling out osteomyelitis, can improve patient outcomes.
- Further research is needed to understand the prevalence and pathogenesis of Heinz-Lippmann disease in CVI.
Abstract:
Chronic venous insufficiency with and without ulceration is a common complication of varicose veins. Heinz-Lippmann disease is a potentially underreported complication of chronic venous insufficiency that involves heterotopic ossification of the peri-wound that might contribute to the chronicity of venous leg ulcers. Most commonly, heterotopic ossification is associated with traumatic injury. We report the cases of three patients with chronic venous insufficiency and no history of trauma who were found to have subcutaneous calcifications consistent with Heinz-Lippmann disease. Osteomyelitis was confirmed in two patients. Physical examination and diagnostic imaging can be helpful in determining the diagnosis. Interventions can include biopsy to rule out osteomyelitis, with subsequent treatment, if needed.
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