Laser Treatment for Lipomembranous Panniculitis with Ulceration
Lipomembranous panniculitis is an uncommon process wherein chronic inflammatory destruction of the fat produces a woody, painful hardening of the skin, especially of the legs. Ulceration may occur. Treatment has often been prolonged and variable in success. The authors herein report a highly successful means of managing the processexcision of the subcutaneous mass using a carbon dioxide laser, producing a pocket-like defect (marsupialization) and healing by secondary intention.
Lipomembranous panniculitis is a fibrotic process that usually occurs in the legs. This condition has also been referred to as lipodermatosclerosis, venous stasis panniculitis, or hypodermitis sclerodermiformis. The principal features are a sclerosing panniculitis with dermal and subcutaneous fibrosis and fat necrosis. Although the exact pathogenesis is uncertain, it is thought to occur as a result of ischemic changes.
The major physical finding is painful, woody thickening in the subcutaneum of the distal one-third of the lower leg. It is usually unilateral and noncircumferential and occasionally ulcerates. A history of deep vein thrombosis and other signs of venous disease may be present including hemosiderosis and/or pitting edema. However, venograms and Doppler investigations are usually normal.
Treatment of the condition is often difficult. The authors herein report a novel, previously unreported method of managementremoval of the entire sclerotic mass using carbon dioxide laser with marsupialization and healing by secondary intention.
Abstract and Introduction
Abstract
Lipomembranous panniculitis is an uncommon process wherein chronic inflammatory destruction of the fat produces a woody, painful hardening of the skin, especially of the legs. Ulceration may occur. Treatment has often been prolonged and variable in success. The authors herein report a highly successful means of managing the processexcision of the subcutaneous mass using a carbon dioxide laser, producing a pocket-like defect (marsupialization) and healing by secondary intention.
Introduction
Lipomembranous panniculitis is a fibrotic process that usually occurs in the legs. This condition has also been referred to as lipodermatosclerosis, venous stasis panniculitis, or hypodermitis sclerodermiformis. The principal features are a sclerosing panniculitis with dermal and subcutaneous fibrosis and fat necrosis. Although the exact pathogenesis is uncertain, it is thought to occur as a result of ischemic changes.
The major physical finding is painful, woody thickening in the subcutaneum of the distal one-third of the lower leg. It is usually unilateral and noncircumferential and occasionally ulcerates. A history of deep vein thrombosis and other signs of venous disease may be present including hemosiderosis and/or pitting edema. However, venograms and Doppler investigations are usually normal.
Treatment of the condition is often difficult. The authors herein report a novel, previously unreported method of managementremoval of the entire sclerotic mass using carbon dioxide laser with marsupialization and healing by secondary intention.
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