Intractable leg ulceration caused by cutaneous cholesterol embolism.
OBJECTIVE
To present a case of chronic intractable leg ulceration caused by cholesterol crystal embolism.


METHODS
A 76-year-old Caucasian male with a history of ischaemic heart disease had repeated hospital admissions for diagnosis and treatment of recurrent leg ulceration of more than three years' duration.


RESULTS
Definitive diagnosis was made after the third biopsy when the specimen obtained included subcutaneous arteries. Complete healing occurred within three weeks of excision and a skin graft, and subsequent treatment which included systemic steroids.


CONCLUSIONS
Cholesterol crystal embolism is probably an underdiagnosed cause of intractable leg ulceration and can be identified by a biopsy specimen which includes vessels in subcutaneous fat. Systemic steroids may be helpful in its treatment.
Davies
D J
DJ
South Western Area Pathology Service, Liverpool, NSW.
Thurasingham
K
K
D000368:Aged; D001706:Biopsy; D002784:Cholesterol; D003460:Crystallization; D004617:Embolism / Q000150:complications* / Q000473:pathology / Q000628:therapy; D006801:Humans; D007871:Leg Ulcer / Q000209:etiology* / Q000473:pathology; D008297:Male; D012008:Recurrence; D012871:Skin Diseases / Q000150:complications* / Q000473:pathology / Q000628:therapy; D016038:Skin Transplantation; D013256:Steroids / Q000627:therapeutic use
D013256:Steroids; D002784:Cholesterol