Cutaneous hyperpigmentation following venous sclerotherapy treated with deferoxamine mesylate

Background. Cutaneous hyperpigmentation after venous sclerotherapy is an adverse sequelae of difficult management. Objective. To evaluate the degree of depigmentation with the use of deferoxamine mesylate (DM) in patients with postsclerotherapy hyperpigmentation treated 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) was 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 veins. Group II consisted of six patients with prolonged postsclerotherapy hyperpigmentation (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% depigmentation was reached. In group I, DM was injected at the time of sclerotherapy. These groups were compared to their respective control groups with similar conditions but allowing spontaneous depigmentation without DM. Evaluation was undertaken clinically and photographically, and the number of days 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 depigmentation was seen at 150 +/- 19 and 255 +/- 11 days, respectively. Comparing 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 prolonged postsclerotherapy hyperpigmentation in varicose veins. In this study we could not explain why such variability exists in the length of time to spontaneous depigmentation.