What Is Hemosiderin?

What is hemosiderin? What causes skin discoloration? Let’s delve deeper to connect the dots with hemosiderin.

How is hemosiderin shaped?

The name hematoidin comes from ancient Greek, where “haima” means blood and “eidos” means resemblance. Therefore, hematoidin would mean “resemblance of blood.” Virchow described Hematoidin (CH) crystals in 1847. They are composed of pigments similar to the yellow-orange bilirubin. CH formation begins when erythrocytes extravasate into the walls of the cavities. They damage and are phagocytosed by macrophages in conditions of little or no oxygen. Subsequently, globin is removed, iron combines with apoferritin, and hemosiderin is formed. 

The hemosiderin porphyrin ring opens, forming reduced biliverdin and giving rise to CH.1 This pigment can be found in any tissue where bleeding has occurred in anaerobiosis and can be a sign of trauma or bleeding. In the light microscope, CHs are deep golden-brown, and their shapes vary from the simple thread, clusters of threads, and star or jellyfish shapes. They are found near areas with extravasation of erythrocytes, and fibrosis and scar tissue are observed in these regions.

How is hemosiderin as a disorder defined?

Hemosiderin affects the lower extremities, especially the inner aspect of the ankles and the tibia.  The dark pigmentation of the skin occurs due to the accumulation of blood, which is a sign of venous insufficiency that, if not treated in time, could cause skin ulceration.

It is usually present in patients with a history of this disease and in patients who, due to their lifestyle, spend many hours standing or sitting. To try to alleviate hemosiderin, rest is performed, including elevation of the legs and elastic stockings.

What is significant to identify in hemosiderin?

Hemosiderin is a skin condition characterized by dark and irregular pigmentation of the lower limbs due to venous insufficiency. Beyond being an aesthetic problem, the iron deposited in the skin greatly influences the evolution of the disease and, consequently, the venous ulcer.

Iron plays an essential role in the body, as it participates in multiple metabolic processes and is involved in tissue cell turnover, regulating DNA replication. However, iron at high levels can be harmful, as it increases oxidative stress. Therefore, the body is responsible for regulating excess iron, but this is not enough when there is an uncontrolled iron overload at the systemic or local level.

It usually affects people with a genetic predisposition, patients suffering from obesity, with a history of many pregnancies, or those who work long hours standing or sitting, which causes dilation of the veins. This causes the veins not to be able to send blood back to the heart properly and the red blood cells are destroyed, forming a brown iron pigment called hemosiderin.

This irregular pigmentation usually increases its intensity in the lower areas, such as the back of the foot or ankle.

What are your symptoms of hemosiderin?

This condition is considered a complication of chronic venous insufficiency and, in addition to presenting hyperpigmentation in the lower limbs, patients suffering from this condition usually show:

• Leg heaviness, as well as swelling and possible cramps
• Varicose veins cause decreased venous return. They are more frequent in women, during the gestation period, due to taking contraceptives, due to genetic factors, or due to obesity.
• Sporadic itching in the affected area, peeling, and skin fragility
• Ulcers
• Stasis eczema, which can cause even more pigmentation, as well as itching and scaling

All these symptoms are aggravated in hot environments and improve when the patient sits with the legs slightly tilted up or with physical exercise.

Causes

The main cause of hemosiderin is slowed venous circulation, which causes increased pressure in the leg veins responsible for transporting blood from the lower limbs to the heart, trying to overcome the force of the blood gravity.

Patients suffering from this condition have dilated veins in the lower limbs, which have a high degree of permeability.

Due to this factor, red blood cells are released, which break down and produce hemosiderin, a dark brown iron pigment that causes stains.

Treatment for hemosiderin

Treatment to combat hemosiderin aims to prevent the condition, reduce its proliferation, mitigate symptoms and avoid possible complications. Also, it is essential to emphasize that the treatment is not usually as effective in already pigmented areas.

Compressive therapy uses elastic bandages or compression stockings to help reduce venous pressure.

It is also essential to avoid being overweight. Try not to lead a sedentary lifestyle, not wear tight clothes, not get too hot or not wear uncomfortable and tight shoes. On the contrary, the disease improves markedly when the patient performs the daily physical exercise, performs frequent upward massage, wears elastic bandages, or elevates the legs several times a day.

The fact that applying cool compresses to the area also relieves the symptoms.

What factors put you at hemosiderin risk?

• Age – The elasticity in the vein walls tends to reduce naturally over time. Therefore the older we get, the more likely we are to develop varicose veins.
• Gender – Although 25% of men risk developing varicose veins, research shows that women are at a much higher risk, close to 40%. Many factors, such as increases in female hormones and pregnancy, increase the risk in women.
• Pregnancies – Many women develop varicose veins for the first time during their pregnancy and have a much higher chance of appearing after the second pregnancy. Research shows that this occurs due to hormonal changes and increased pressure in all the veins with the expansion of the uterus.
• Lifestyle – People who sit or stand for long periods of time increase their risk of developing varicose veins. This happens because the blood tends to pool in certain areas of the legs where there is no pressure from the muscles against the veins. Exercise and muscle compression help blood flow upward.
• Obesity – Being excessively overweight causes increased pressure in the veins, restricting healthy blood flow.
• Injuries – Certain injuries or shocks can cause valve failure.

Is there any hemosiderin treatment at the USA Veins Clinic?

Hemosiderin is achieved after a hematological examination. For the diagnosis of iron deficiency anemia to be correct, it must be shown that there is a depletion of body iron stores.

In most cases, there is microcytosis. For the differential diagnosis of iron deficiency anemia and those secondary to a chronic inflammatory process, it is necessary to look at the ferritin values. In iron-deficiency anemias, it remains elevated until the reserves have been restored.

The transferrin saturation coefficient is decreased below 16%, indicating an insufficient iron supply to the erythroblasts. Once the iron deficiency is known, hemosiderin must be sought.

To treat hemosiderin, get in touch with  USA Vein Clinics.