Also known as: lipodermatosclerosis, hypodermitis sclerodermiformis, lipomembranous fat necrosis, lipomembranous change in chronic panniculitis, stasis-associated lipomembranous panniculitis, stasis-related sclerosing panniculitis
- Secondary to venous stasis, leading to fat necrosis and fibrosis
- Most commonly affects adult women.
- Presents with erythematous indurated plaques on the distal lower extremities, described as having an "inverted bottle" appearance
- The overlying skin usually shows changes of stasis dermatitis.
- Septal and lobular panniculitis with early perivascular lymphycytic infiltrates
- Ischemic fat necrosis with:
- Early pallor of adipocytes with loss of nuclei, karyorrhexis, hemorrhage and hemosiderin deposition
- Progressive fibrosis of the septa with fibrous obliteration of the fat lobules
- Progressive fat necrosis with formation of microcysts and lipomembranous change (cystic spaces lined by feathery eosinophilic membranes said to resemble parasitic cuticles, PAS positive)