Lipodermatosclerosis and diabetic dermopathy are low-risk skin lesions with many similar clinical features, except for venous abnormalities such as chronic venous insufficiency, but are rarely a reason for referring the patient to vascular ultrasound examination. We present 3 serial cases in which the compression ultrasound examination (CUS) of the venous circulation of the affected limbs was of utmost importance in the severity stratification. Asymptomatic deep venous thrombosis (DVT) was found in the first two cases, while in the third case the CUS excluded any type of vascular involvement, leading to a definite diagnosis of diabetic dermopathy. Lipodermatosclerosis may be associated with asymptomatic DVT due to chronic venous insufficiency, and early referral to CUS positively impacts further patient management.
If the inline PDF is not rendering correctly, you can download the PDF file here.
1. Heit JA. The epidemiology of venous thromboembolism in the community. Arterioscler Thromb Vasc Biol. 2008;28:370-372.
2. Naschitz JE Yeshurun D Schwartz H et al. Pathogenesis of lipodermatosclerosis of venous disease: the lesson learned from eosinophilic fasciitis. Cardiovasc Surg Lond Engl. 1993;1:524-529.
3. Gross EA Wood CR Lazarus GS Margolis DJ. Venous leg ulcers: an analysis of underlying venous disease. Br J Dermatol. 1993;129:270-274.
4. Caggiati A Rosi C Casini A et al. Skin iron deposition characterises lipodermatosclerosis and leg ulcer. Eur J Vasc Endovasc Surg. 2010;40:777-782.
5. Hafner C Wimmershoff M Landthaler M Vogt T. Lipodermatosclerosis: successful treatment with danazol. Acta Derm Venereol. 2005;85:365-366.
6. Walsh SN Santa Cruz DJ. Lipodermatosclerosis: a clinicopathological study of 25 cases. J Am Acad Dermatol. 2010;62:1005-1012.
7. Ferringer T Miller F. Cutaneous manifestations of diabetes mellitus. Dermatol Clin. 2002;20:483-492.
8. Brugler A Thompson S Turner S Ngo B Rendell M. Skin blood flow abnormalities in diabetic dermopathy. J Am Acad Dermatol. 2011;65:559-563.
9. American Institute of Ultrasound in Medicine American College of Radiology Society of Radiologists in Ultrasound. Practice guideline for the performance of peripheral venous ultrasound examinations. J Ultrasound Med. 2011;30:143-150.
10. Bressollette L Nonent M Oger E et al. Diagnostic accuracy of compression ultrasonography for the detection of asymptomatic deep venous thrombosis in medical patients – the TADEUS project. Thromb Haemost. 2001;86:529-533.