case_images: PMC10316411_01
case_images: Initial treatment
case_images: GMS-21-04-g-001.jpg
case_images: PMC10316411_01_GMS-21-04-g-001.jpg
case_images: F1
case_images: A 55-year-old patient with an eight-year history of edema of the lower limb of the leg had constant episodes of erysipelas, despite regular treatments (Figure 1 (Fig. 1)).
case_images: Skin with an intense formation of crust
case_images: GMS-21-04-g-002.jpg
case_images: PMC10316411_01_GMS-21-04-g-002.jpg
case_images: F2
case_images: The edema progressed continually, associated with a change in the color of the skin and the formation of a crust (Figure 2 (Fig. 2)). The physical examination revealed lymphedema that limited the mobility of the ankle and a hardened crust below the knee (Figure 2 (Fig. 2)).
case_images: After treatment
case_images: GMS-21-04-g-003.jpg
case_images: PMC10316411_01_GMS-21-04-g-003.jpg
case_images: F3
case_images: The reduction in volume of the limb was constant with treatment (Figure 3 (Fig. 3)).
case_images: Considerable peeling of the skin, which remains dry and dehydrated despite constant moisturizing
case_images: GMS-21-04-g-004.jpg
case_images: PMC10316411_01_GMS-21-04-g-004.jpg
case_images: F4
case_images: The skin received moisturizing and peeling occurred (Figure 4 (Fig. 4)).
case_images: High-frequency ultrasound. Left side of the image: normal right lower limb; right side of the image: left lower limb with lymphedema and disarrangement of skin structures
case_images: GMS-21-04-g-005.jpg
case_images: PMC10316411_01_GMS-21-04-g-005.jpg
case_images: F5
case_images: At this point, HFUS was performed, which revealed the disarrangement of the structures of the dermal layers and intensive fibrosis (Figure 5 (Fig. 5)).
case_images: Skin with substantial improvement, achieving near clinical normality
case_images: GMS-21-04-g-006.jpg
case_images: PMC10316411_01_GMS-21-04-g-006.jpg
case_images: F6
case_images: Treatment led to considerable improvement in the skin to standards close to normality (Figure 6 (Fig. 6)) and a new ultrasound was performed (Figure 7 (Fig. 7)).
case_images: Post-treatment ultrasound showing the onset of the reconstruction of the skin layers
case_images: GMS-21-04-g-007.jpg
case_images: PMC10316411_01_GMS-21-04-g-007.jpg
case_images: F7
case_images: Treatment led to considerable improvement in the skin to standards close to normality (Figure 6 (Fig. 6)) and a new ultrasound was performed (Figure 7 (Fig. 7)).