Membranous lipodystrophy

Editor: unassigned

Also known as: lipodermatosclerosis, hypodermitis sclerodermiformis, lipomembranous fat necrosis, lipomembranous change in chronic panniculitis, stasis-associated lipomembranous panniculitis, stasis-related sclerosing panniculitis

Clinical Features:

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

Histologic Features:

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)

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