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Pain may be the first noticed symptom. [3] People with lipodermatosclerosis have tapering of their legs above the ankles, forming a constricting band resembling an inverted champagne bottle. [ 3 ] [ 5 ] In addition, there may be brownish-red pigmentation and induration .
Patients present with an acute onset of swelling, pain, erythema, prominent tenderness, warmness and limited range of motion in both ankles. [1] [2] Lower legs and heels may also be involved, however the distal parts of feet and toes are usually spared. Patients may also experience high-graded fever, pitting edema and hypotension.
Grade 1 (mild edema): Involves the distal parts such as a forearm and hand or a lower leg and foot. The difference in circumference is less than 4 cm (1.6 in) and no other tissue changes are present. Grade 2 (moderate edema): Involves an entire limb or corresponding quadrant of the trunk. Difference in circumference is 4–6 cm (1.6–2.4 in).
Fat deposits/swelling in legs and arms not in hands or feet; hands and feet may be affected as the disease progresses. Fat deposits / swelling widespread in legs/arms/torso: Fat deposits/swelling in one limb including hands and feet: Fat deposits widespread Swelling near ankles; brownish discoloration of lower legs (hemosiderin deposits).
Swelling: Some individuals may experience slight swelling (edema) in the lower legs alongside the rash. This swelling is typically mild and localized to the affected areas. [3] [2] Burning sensation: A burning or stinging sensation in the affected skin is commonly reported. This discomfort can range from mild to moderate in intensity. [3] [6]
Myxedema's characteristic physical sign is non-pitting edema, in contrast to pitting edema. [1] Myxedema can also occur in the lower leg (pretibial myxedema) and behind the eyes (exophthalmos). [citation needed] Severe cases, requiring hospitalization can exhibit signs of hypothermia, hypoglycemia, hypotension, respiratory depression, and coma.