LB876 Acute inflammatory edema: A challenging diagnosis in a critically ill patient

A 55-year-old man with a prior history of fibrotic lung disease was admitted to the hospital for bilateral transplantation. His post-operational course complicated by severe volume overload requiring initiation continuous veno-venous hemodialysis (CVVHD). During this hospitalization, he had developed erythematous plaques over his thighs. Examination revealed and edematous peau d’orange appearance extending thighs abdominal pannus. Importantly, inguinal infra-abdominal folds were spared. The clinical differential diagnosis included acute inflammatory edema (AIE), early lipodermatosclerosis (LDS), stasis change. Punch biopsy thigh lesion prominent dermal edema, sparse perivascular interstitial lymphohistiocytic infiltrate, ectactic vessels, fibrosis: findings consistent AIE. Improvement patient’s status, increased mobility, frequent position changes recommended. AIE is variant pseudocellulitis characterized primarily found on abdomen that spare areas pressure, such as folds. an lymphedema predominantly affects critically ill patients hypoalbuminemia, body mass index, renal impairment, evidence fluid overload. LDS dermatitis can also present pannus; however, these conditions commonly manifest distal lower extremities do not skin Additionally, are typically chronic rather than acute. lobular panniculitis fat necrosis, lipomembranous change, septal fibrosis. In stasis, there number thickened capillaries, red blood cell extravasation, siderophages.