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The management of lipodermatosclerosis may include treating venous insufficiency with leg elevation and elastic compression stockings. [9] In some difficult cases, the condition may be improved with the additional use of the fibrinolytic agent, stanozol. Fibrinolytic agents use an enzymatic action to help dissolve blood clots.
Because of its similarities to deep vein thrombosis (DVT), May–Thurner syndrome is rarely diagnosed amongst the general population. In this condition, the right iliac artery sequesters and compresses the left common iliac vein against the lumbar section of the spine, [5] resulting in swelling of the legs and ankles, pain, tingling, and/or numbness in the legs and feet. [6]
The legs and face are the most common sites involved, although cellulitis can occur on any part of the body. [1] The leg is typically affected following a break in the skin. [1] Other risk factors include obesity, leg swelling, and old age. [1] For facial infections, a break in the skin beforehand is not usually the case. [1]
Ultrasound is indicated if superficial phlebitis involves or extends into the proximal one-third of the medial thigh, there is evidence for clinical extension of phlebitis, lower extremity swelling is greater than would be expected from a superficial phlebitis alone or diagnosis of superficial thrombophlebitis in question.
The result is edema, pain and a white appearance (alba) of the leg. The next step in the disease progression is occlusion of the superficial venous system, thereby preventing all venous outflow from the extremity. At this stage it is called phlegmasia cerulea dolens. The leg becomes more swollen and increasingly more painful.
Skin ulcers appear as open craters, often round, with layers of skin that have eroded. The skin around the ulcer may be red, swollen, and tender. Patients may feel pain on the skin around the ulcer, and fluid may ooze from the ulcer. In some cases, ulcers can bleed and, rarely, patients experience fever. Ulcers sometimes seem not to heal ...
Stasis dermatitis is diagnosed clinically by assessing the appearance of red plaques on the lower legs and the inner side of the ankle. Stasis dermatitis can resemble a number of other conditions, such as cellulitis and contact dermatitis, and at times needs the use of a duplex ultrasound to confirm the diagnosis or if clinical diagnosis alone is not sufficient.
Ultrasonography of chronic venous insufficiency of the legs allows the examiner to evaluate the gross anatomy of the venous networks as well as the blood flow direction, which is crucial in determining vein pathology. It has become the reference standard used in the assessment of the condition and hemodynamics of the veins of the lower limbs. [1]