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The exact cause of lipodermatosclerosis is unknown. [3] [6] Venous disease, such as venous incompetence, venous hypertension, and body mass may be relevant to the underlying pathogenesis. [3] Increased blood pressure in the veins (venous hypertension) can cause diffusion of substances, including fibrin, out of capillaries.
There is a recurrent acute and chronic inflammation and thrombosis of arteries and veins of the hands and feet. The main symptom is pain in the affected areas, at rest and while walking (claudication). [1] The impaired circulation increases sensitivity to cold. Peripheral pulses are diminished or absent. There are color changes in the extremities.
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.
Individuals affected by RS3PE typically have repeated episodes of inflammation of the lining of their synovial joints and swelling of the end portion of the limbs. [8] The arms and hands are more commonly affected than the legs and feet. [8] Both sides are usually involved though RS3PE can affect only one side in certain cases. [8]
Swelling of the limb may cause inhibited flow by increased pressure, and in the legs (but very rarely in the arms), this may indicate a fasciotomy, opening up all four leg compartments. [8] Because of the high recurrence rates of thromboembolism, it is necessary to administer anticoagulant therapy as well. [11]
While it's more common in kids, with reported rates of 5% experiencing an episode within the previous year, as many as 1.5% of adults also report walking in their sleep each year.
Common manifestations of sensory issues include numbness or painful sensations in the arms and legs, abnormal sensations like "pins and needles," and heat intolerance. [5] Pain experienced by individuals depends on the severity of the polyneuropathy. It may be dull and constant in some individuals while being sharp and lancinating in others. [4]
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