Lipodermatosclerosis (LDS) is a condition commonly seen in patients who have chronic long-term venous disease. As with pigment changes and stasis dermatitis, lipodermatosclerosis occurs when blood pools within the veins, leading to increased pressure and leakage of fluid beneath the surface of the skin. This results in ongoing inflammation in the subcutaneous fat and surrounding tissues so that the skin begins to feel thickened and tough or “woody.” Lipodermatosclerosis is a painful condition due to the swelling, pressure and chronic inflammation.
Unfortunately, once lipodermatosclerosis is established, it is difficult to reverse. The sooner a patient undergoes treatment to correct the underlying venous insufficiency, the better, as less permanent damage will have been done.
Treatment should be focused on improving comfort and function and preventing the lipodermatosclerosis from progressing into ulcers. Patients may find temporary improvement of symptoms with compression stockings, but further treatment is necessary to keep the condition from progressing. Treatments for lipodermatosclerosis include endovenous laser ablation techniques and/or ultrasound-guided sclerotherapy techniques.