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
Resumo
Palavras-chave
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
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.