Cutaneous hyperpigmentation following venous sclerotherapy treated with deferoxamine mesylate

Background. Cutaneous hyperpigmentation after venous sclerotherapy is an ad verse sequelae of difficult management. Objective. To evaluate the degree of depigmentation with the use of deferox amine mesylate (DM) in patients with postsclerotherapy hyperpigmentation tr eated with polydocanol (POL) for telangiectasias and reticular veins (0.2-5 mm diameter) and varicose veins (5-8 mm diameter). Methods. The experimental group of 36 female patients (mean age 37 years) w as divided in two groups. Group I consisted of 30 patients who were treated with POL at 0.25-0.50% concentration for telangiectasias and reticular vei ns. Group II consisted of six patients with prolonged postsclerotherapy hyp erpigmentation (more than 6 months after treatment) in varicose veins that had been treated with POL at 1.5 % concentration each week. Groups I and II were injected with DM 500 mg subcutaneously once a week until 81-100% depi gmentation was reached. In group I, DM was injected at the time of scleroth erapy. These groups were compared to their respective control groups with s imilar conditions but allowing spontaneous depigmentation without DM. Evalu ation was undertaken clinically and photographically, and the number of day s required to reach the desired depigmentation of 81-100% was determined. Results. When DM was used, depigmentation of 81-100% was observed in group I at 27 days, and for group II in 46 days. In each control group, similar d epigmentation was seen at 150 +/- 19 and 255 +/- 11 days, respectively. Com paring results, there was a reduction in the time to depigmentation of 82% for each group (P<.0001). Conclusion. The weekly subcutaneous administration of DM 500 mg reduces the time to depigmentation by 82% in patients with postsclerotherapy cutaneous hyperpigmentation treated for telangiectasias and reticular veins and prol onged postsclerotherapy hyperpigmentation in varicose veins. In this study we could not explain why such variability exists in the length of time to s pontaneous depigmentation.