Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.190031
Jornal Vascular Brasileiro
Case Report

Oxandrolona no tratamento da lipodermatoesclerose: relato de caso

Oxandrolone for treatment of lipodermatosclerosis: case report

Leonardo Amédée Péret; Heloisa Malaquias Vidal; Gabriela Alves Cardoso Gomes; Gabriel Victor Borba Oliveira; Lainara Magalhães Aguiar

Downloads: 0
Views: 21

Resumo

Resumo: A lipodermatoesclerose é uma paniculite que se caracteriza por endurecimento e hiperpigmentação da pele envolvendo as panturrilhas, com a aparência de “garrafa de champanhe invertida”. Muitas abordagens terapêuticas têm sido recomendadas, mas o uso de oxandrolona para essa finalidade foi pouco estudado até o momento. Relatamos um caso de lipodermatoesclerose aguda em uma mulher de 61 anos, com história prévia de tratamento cirúrgico para insuficiência venosa de membros inferiores. A paciente apresentava edema e lesões dolorosas e eritematosas com infiltração difusa, que acometiam principalmente a face posterior da panturrilha esquerda. Foi tratada inicialmente com estanozolol e pentoxifilina, com boa resposta. Devido à indisponibilidade do estanozolol, iniciou-se o uso de oxandrolona. Esse tratamento foi bem tolerado, resultando em redução significativa do edema, do eritema e da infiltração presentes nos membros inferiores, além de alívio da dor. A oxandrolona pode representar uma opção útil e segura no tratamento da lipodermatoesclerose aguda.

Palavras-chave

paniculite, oxandrolona, insuficiência venosa, relatos de casos

Abstract

Abstract: Lipodermatosclerosis is a panniculitis characterized by hardening and hyperpigmentation of the skin involving the calves with an “inverted champagne bottle” appearance. Many therapeutic approaches have been recommended, but the use of oxandrolone for this purpose has been studied very little to date. We report a case of acute lipodermatosclerosis in a 61-year-old woman with a previous history of surgical treatment for venous insufficiency of the lower limbs. The patient presented with edema and painful, erythematous lesions with diffuse infiltration, mainly affecting the posterior aspect of the left calf. She was initially treated with stanozolol and pentoxifylline, with good response. Due to unavailability of stanozolol, she was put on oxandrolone. This treatment was well tolerated, reduced the intensity of edema, erythema, and infiltration in the lower limbs, effectively leading to pain relief. Oxandrolone may be a useful and safe treatment for patients with acute lipodermatosclerosis.
 

Keywords

lipodermatosclerosis, oxandrolone, venous insufficiency, case reports

References

Bruce AJ, Bennett DD, Lohse CM, Rooke TW, Davis MDP. Lipodermatosclerosis: review of cases evaluated at Mayo Clinic. J Am Acad Dermatol. 2002;46(2):187-92. http://dx.doi.org/10.1067/mjd.2002.119101. PMid:11807428.

Charoen C, Suteeraporn C, Narachai J. Lipodermatosclerosis: a clinicopathologic correlation. Int J Dermatol. 2016;55(3):303-8. http://dx.doi.org/10.1111/ijd.12856. PMid:26275890.

Araújo I. Ensaio clínico randomizado e duplo cego de curativos bioativos: cola de fibrina versus gel de papaína® no processo de cicatrização de úlceras crônicas de etiologia venosa [tese]. Botucatu: Universidade Estadual Paulista; 2012.

Maffei FHA. Insuficiência venosa crônica: conceito, prevalência etiopatogenia e fisiopatologia. In: Maffei FHA, Yoshida WB, Rollo HA et al. Doenças vasculares periféricas. Rio de Janeiro: Guanabara Koogan; 2008. p. 1581-90.

Patterson J. Paniculites. In: Bolognia JL, Jorizzo JL, Schaffer JV. Dermatologia. Rio de Janeiro: Elsevier; 2015. p. 1641-62.

Kirsner RS, Pardes JB, Eaglstein WH, Falanga V. The clinical spectrum of lipodermatosclerosis. J Am Acad Dermatol. 1993;28(4):623-7. http://dx.doi.org/10.1016/0190-9622(93)70085-8. PMid:8463465.

Segal S, Cooper J, Bolognia J. Treatment of lipodermatosclerosis with oxandrolone in a patient with stanozolol-induced hepatotoxicity. J Am Acad Dermatol. 2000;43(3):558-9. http://dx.doi.org/10.1067/mjd.2000.106517. PMid:10954677.

Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley DS. The CARE guidelines: consensus-based clinical case report guideline development. Glob Adv Health Med. 2013;2(5):38-43. http://dx.doi.org/10.7453/gahmj.2013.008. PMid:24416692.

Choonhakarn C, Chaowattanapanit S. Lipodermatosclerosis: Improvement noted with hydroxychloroquine and pentoxifylline. J Am Acad Dermatol. 2012;66(6):1013-4. http://dx.doi.org/10.1016/j.jaad.2011.11.942. PMid:22583718.

Gohel M, Barwell J, Taylor M, et al. Long term results of compression therapy alone versus compression plus surgery in chronic venous ulceration (ESCHAR): randomised controlled trial. BMJ. 2007;335(7610):83. http://dx.doi.org/10.1136/bmj.39216.542442.BE. PMid:17545185.

Carson P, Hong C, Otero-Vinas M, Arsenault E, Falanga V. Liver Enzymes and Lipid Levels in Patients With Lipodermatosclerosis and Venous Ulcers Treated With a Prototypic Anabolic Steroid (Stanozolol): a prospective, randomized, double- blinded, placebo-controlled trial. Int J Low Extrem Wounds. 2015;14(1):11-8. http://dx.doi.org/10.1177/1534734614562276. PMid:25652757.

Vesić S, Vuković J, Medenica LJ, Pavlović MD. Acute lipodermatosclerosis: an open clinical trial of stanozolol in patients unable to sustain compression therapy. Dermatol Online J. 2016;14(2):1. PMid:18700104.

Hafner C, Wimmershoff M, Landthaler M, Vogt T. Lipodermatosclerosis: Successful Treatment with Danazol. Acta Derm Venereol. 2004;85(22):365-6. PMid:16191868.

Santana L, Belatti A, Montero D, Capellato N, Chiappetta M, Galimberti R. Lipodermatoesclerosis aguda. Las celulitis que nunca fueron. Derm CMQ. 2016;14(1):7-11.

Cicardi M, Zuraw B. Hereditary angioedema: general care and long-term prophylaxis [citado 2017 mar 7]. https://www.uptodate.com

Neves A, Miranda A, Martins H, Barradas R. Pentoxifilina no tratamento da úlcera venosa: uma revisão baseada na evidência. Rev Port Med Geral Fam. 2016;32:198-204.
 

5dc1be790e8825a677b2a977 jvb Articles

J Vasc Bras

Share this page
Page Sections