Sclerosing panniculitis. A clinicopathologic assessment

Procollagen type I gene expression and cell proliferation are increased in lipodermatosclerosis

“…Moreover, the presence of procollagen‐producing cells in the fat septa supports a theory proposed by Browse and Burnand, that LDS is characterized by the ‘progressive replacement of the subcutaneous fat by fibrotic tissue’ 22 . Although the amount of collagen production and its degradation were not quantified in the present study, it is clear from our histological observations and those of others 9,21 that an imbalance in collagen turnover exists in LDS in favour of collagen deposition. Although several studies have reported elevated matrix metalloproteinase 23 and fibrinolytic 24 activity in LDS samples, tissue breakdown and ulceration are not likely to occur until there is a change in favour of collagen degradation.…”

Lipodermatosclerosis: a clinicopathologic study of 17 cases and differential diagnosis from erythema nodosum

“…Our study confirmed that LDS is a fibrosing septolobular panniculitis with fat necrosis associated with venous stasis. In the paper by Jorizzo et al, 3 The histopathologic changes in our series are similar to those of the three corresponding stages described by Jorizzo et al 3 with the exception of having less prominent central lobular ischemic necrosis in the acute lesions and dermal atrophy in the chronic lesions. The differences might be attributed to sample variation and the fact that the present series did not include very advanced cases of LDS.…”

“…The patients in our study were predominantly female, a finding also noted in other studies. 3,7 Obesity was a prominent clinical feature in LDS reported by Bruce et al; 7 however, only a few of our patients appeared overweight. Venous stasis on the lower legs was observed in all patients in our series.…”

Lipodermatosclerosis

“…Because membranocystic fat necrosis is a key feature of LDS, its diagnostic utility deserves a short discussion. As reported by previous authors (13,17,30), it is a nonspecific finding in the fat lobules that could also be found in other types of panniculitis. Snow et al.…”