Last Wednesday I showed you hemosiderin deposits in an unusual location. This week you can see skin changes that mimic classic hemosiderin but are not due to venous insufficiency. Iron overload, also known as haemochromatosis, is an accumulation of iron in the body from any cause. There are really 2 types: primary cases (hereditary or genetically determined) and less frequent secondary cases. Hereditary haemochromatosis (HHC) is a genetic disorder.
People of Celtic (Irish, Scottish, Welsh, Cornish, Breton etc.), British, and Scandinavian origin have a particularly high incidence, of whom about 10% are carriers of the gene and 1% suffer from the condition. Secondary causes include transfusional iron overload, which can result from repeated blood transfusions usually needed by individuals with a hereditary anaemia (such as beta-thalassaemia major, or sickle cell anaemia) or by patients with severe acquired anaemia (e.g. myelodysplastic syndrome). It can also be caused by excess parenteral iron supplements. This young woman is less than 20. You would have known her skin changes were not due to stasis since she has absolutely no lower extremity edema at all, and she also has darkening of the skin on her arms which I didn’t show you.
Caroline Fife, MD
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