CASE REPORTS C ase One. A 57 year old post-menopausal Caucasian female, Gravida3, Para3, presented for compression sclerotherapy of bilateral varicosities of the lower limbs. She had no significant medical or surgical history other than recent onset of non-insulin dependent diabetes mellitus for which she was taking metformin hydrochloride 500 mg daily. She was not on any hormone replacement or iron supplements and there was no history of smoking or regular alcohol consumption. She had no previous recorded problems in relation to excess body hair. She did complain of previous allergies to shellfish. Clinically, she had trophic skin changes on both medial ankles, bilateral varicosities of the long saphenous veins [LSV], prominent varicosities of the antero-lateral thigh veins, and tortuous varices of the lateral thigh, lateral calf, and infra-patellar veins. She also had prominent vulvar varicosities, and widespread venulectases and telangiectases (C4s EpA 1R, 2R, 3R, 5R, 17R PR) 1 . Doppler examination revealed a bilateral Hach grade IV incompetence of LSVs with gross Saphenofemoral junction [SFJ] reflux. She also had bilateral incompetence of the perforators of popliteal fossae. Both Saphenopopliteal junctions [SPJ] were competent. Echosclerotherapy procedure was performed treating the right SFJ followed by the trunk of LSV and its distal tributaries. The right anterolateral thigh vein was treated a week later. She remained in a class II graduated compression stocking for a period of two weeks. Two weeks later a similar procedure was repeated on her left leg. The patient progressed satisfactorily and reported no adverse effects in the post-treatment period other than a patch of hair growth in the left anterior thigh eight weeks after the treatment. On examination, there was a 10 x 5cm patch of terminal body hair measuring 1 cm in length occurring over the recently treated left antero-lateral thigh varicosity on a background of mild hyperpigmentation. The appearance of hypertrichosis was striking in that it occurred over a minimally hair bearing area of the thigh. The corresponding area of the contra-lateral thigh revealed some mild hemosiderin staining but showed no evidence of excessive growth of terminal hair. Repeat Doppler examination showed that the truncal and axial varicosities of both legs were well sclerosed with no evidence of reflux over the area affected by hypertrichosis. Three months later, the hypertrichosis had completely resolved. The underlying varicosity was no longer present with normal vellus hair growing on the overlying skin, similar to the contralateral thigh. Address correspondence and reprint requests to: Dr Kurosh Parsi, P0 Box 419, Wentworth Building, University of Sydney NSW 2006 Australia. Tel: +61 2 9386 0211 Fax: +61 2 9386 0258 * English translation reprinted with permission from Phlebologie, Annales Vasculaires 1999; 52(3):335-339 Case P R E S E N T A T I O N Post-Sclerotherapy Hypertrichosis Two case reports,a local survey of incidence and a discussion of pathogenesis* A LIM 1 AND K PARSI 2 1 Department of Dermatology, St George Hospital, Kogarah, NSW, Australia and 2 Skin and Cancer Foundation Australia, Darlinghurst, NSW, Australia. 59 A USTRALIAN & N EW Z EALAND J OURNAL OF P HLEBOLOGY V OLUME 3(2):November 1999 Hypertrichosis is a very rare complication of sclerotherapy. There have been only seven documented cases in three separate reports in the literature. We report two cases of localised hypertrichosis following compression sclerotherapy. We also present the results of a telephone survey of 30 practising sclerotherapists in New South Wales, Australia.The pathogenesis of this condition remains unknown. Recent advances in molecular biology have demonstrated a role for various inflammatory mediators, growth factors, neuropeptides and cytokines in the stimulation of hair follicle growth. We review recent work in this area in an attempt to reconcile our current understanding of the effects of inflammatory mediators with the pathogenesis of post- sclerotherapy hypertrichosis. ABSTRACT pp59 - 62