Hypodermitis sclerodermiformis. Successful treatment with ultrasound

Rowe, Lindsay J.

doi:10.1001/archderm.118.5.312

Cited by 8 publications

(1 citation statement)

References 6 publications

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“…Skin lesions such as hypodermitis are indurated chronic ulcerated lesions related to venous insufficiency. 'Puffy hands' result from longstanding injecting into veins on the dorsum of the hand and chronic lymphatic damage [15,16].…”

Section: Clinical Presentation Acute and Chronic Conditionsmentioning

confidence: 99%

Injecting drug use, the skin and vasculature

2020

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Damage to the skin, subcutaneous tissues and blood vessels are among the most common health harms related to injecting drug use. From a limited range of early reports of injecting-related skin and soft tissue damage there is now an increasing literature relating to new drugs, new contaminants and problems associated with unsafe injection practices. Clinical issues range from ubiquitous problems associated with repeated minor localised injection trauma to skin and soft tissue and infections around injection sites, to systemic blood infections and chronic vascular disease. The interplay of limited availability and access to sterile injecting equipment, poor injecting technique, compromised drug purity, drug toxicity and difficult personal and environmental conditions give rise to injection-related health harms. This review of injecting-related skin, soft tissue and vascular damage focuses on epidemiology and causation, clinical examination and investigation, treatment and prevention.

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Section: Clinical Presentation Acute and Chronic Conditionsmentioning

confidence: 99%

Injecting drug use, the skin and vasculature

2020

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Sclerosing Panniculitis

et al. 1991

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Six patients with well-circumscribed, indurated, inflammatory plaques of the lower extremity are described. Incisional biopsy specimens in each patient revealed fat necrosis, sclerosis, and a lobular panniculitis. These patients are similar to those described under the designations hypodermitis sclerodermaformis or lipodermatosclerosis. The name sclerosing panniculitis is proposed to unify these conditions. The pathogenesis is unknown, although a role for venous stasis or previous thrombophlebitis has been proposed. Systemic or local anti-inflammatory therapies have not been clinically effective.

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Ultrasound Therapy for Lipodermatosclerosis

Damian¹,

Yiasemides²,

Gupta³

et al. 2009

Arch Dermatol

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in 4 cases. All 17 patients in group 1 and 6 of 8 in group 2 achieved a complete response, but 10 experienced relapse in the skin (n=8), the skin and lymph nodes (n=1), or the central nervous system (n = 1). Four patients had multiple successive cutaneous relapses. Treatment of relapses included surgery (1 case), radiotherapy (4 cases), rituximab (1 case), ibritumomab tiuxetan (1 case), and/or various chemotherapies (4 cases). No patient was lost to follow-up. After a 33-month median follow-up, 20 patients were alive (including 13 in complete remission), 3 had died of lymphoma, and 2 had died of unrelated causes. The 3-year disease-specific survival rate was 87%.Nine patients (36%) had at least 1 grade 3 or higher adverse event, including grade 3 (n=2) or grade 4 (n=5) neutropenia, grade 4 thrombocytopenia (n = 1), grade 4 neutropenic sepsis (n=1), grade 3 cardiac failure (n=1), grade 3 pneumonia (n = 1), and grade 3 venous thrombosis (n=1; this patient had a catheter). One patient died of neutropenic septicemia.These 25 patients treated with R-PCT were compared with a historic series of 47 patients with PCLBCL-LT who received other therapies only, as detailed in a previous study. 2 The 2 groups did not differ by classic prognostic factors, 2 including age (median ages, 76 vs 78 years) (P=.30), location of skin lesions, clinical stage at diagnosis, performance status, or lactic dehydrogenase level. However, the percentage of patients who achieved a complete response (92% vs 64%) (P=.01) and the 3-year specific survival rates (87% vs 50%) (P= .004) were much higher in patients treated with R-PCT.

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Hypodermitis sclerodermiformis. Successful treatment with ultrasound

Cited by 8 publications

References 6 publications

Injecting drug use, the skin and vasculature

Injecting drug use, the skin and vasculature

Sclerosing Panniculitis

Ultrasound Therapy for Lipodermatosclerosis

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