The "inverted champagne bottle" appearance of the distal leg is a specific finding associated with this condition. Lipodermatosclerosis usually occurs in patients with longstanding venous insufficiency.
The patient, an active 49-year-old man, had an HbA1c of 8.6 after diabetes was first diagnosed. It’s now 7.6 with metformin and lifestyle measures. Is the current A1c goal adequate, or should you treat more aggressively?