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Venous Abnormalities in Biopsy-confirmed Lipodermatosclerosis.

Vishal Garimella1, George Tinotenda Mukosera1, David A Liedl2

  • 1Department of Dermatology, Mayo Clinic, Rochester, MN.

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|February 6, 2026
PubMed
Summary
This summary is machine-generated.

Lipodermatosclerosis (LDS) is frequently linked to venous abnormalities, with over 75% of patients showing abnormal venous ultrasonography. While venous issues are common, some LDS cases suggest other contributing factors to its development.

Keywords:
quality improvementvascular imaging/diagnosticsvenous insufficiency

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Area of Science:

  • Vascular Medicine
  • Dermatology
  • Pathophysiology

Background:

  • Lipodermatosclerosis (LDS) is a chronic inflammatory condition affecting the lower extremities, characterized by skin hardening, pigmentation, and erythema.
  • It frequently necessitates consultations across various medical specialties, including dermatology and vascular medicine.

Purpose of the Study:

  • To investigate the prevalence of venous hypertension in patients diagnosed with lipodermatosclerosis (LDS).
  • To assess the role of venous abnormalities in the pathogenesis of LDS.

Main Methods:

  • Retrospective review of lower extremity Doppler ultrasonography findings in adult patients with biopsy-confirmed LDS.
  • Analysis included data from January 2000 to September 2022.
  • Further venous hemodynamics studies (air plethysmography, continuous-wave Doppler) were performed for a subset of patients with normal initial ultrasonography.

Main Results:

  • Out of 430 patients, 76.0% (327) exhibited abnormal venous ultrasonography findings.
  • In patients with initially normal venous ultrasonography, further testing revealed mild valvular incompetence (7 patients), abnormal calf muscle pump function (12 patients), or venous pulsatility (2 patients).

Conclusions:

  • The study reinforces the common association between venous abnormalities and lipodermatosclerosis (LDS).
  • These venous findings likely contribute to the development of LDS.
  • The presence of LDS in some patients with normal venous hemodynamics indicates that other pathogenic factors are also involved.