Louisiana Heart & Vascular Institute Vein Care Centers

Hemosiderin Staining

Hemosiderin staining, also known as hemosiderosis or iron staining, refers to the accumulation of hemosiderin, a yellow-brown or rust-colored pigment, in tissues. Hemosiderin is a complex of iron and protein that is formed as a result of the breakdown of red blood cells. This accumulation of hemosiderin is often seen in various medical conditions, particularly those involving chronic bleeding or increased breakdown of red blood cells. Hemosiderin staining can occur in organs, tissues, and skin, and it is commonly associated with conditions such as hemochromatosis, venous insufficiency, and certain types of skin discoloration.

Here’s how hemosiderin staining occurs and its significance in different contexts:

Iron Metabolism and Red Blood Cell Breakdown: Hemosiderin is formed when the body’s iron stores exceed the capacity of binding proteins like ferritin to store iron. This can happen when there is an increased release of iron from hemoglobin, which is found in red blood cells. When red blood cells break down, the heme component of hemoglobin is metabolized, and iron is released. Excess iron that cannot be immediately used is stored as hemosiderin.

Chronic Bleeding or Hemolysis Hemosiderin staining is often associated with conditions where there is chronic bleeding or increased destruction of red blood cells. Chronic bleeding can occur due to conditions such as gastrointestinal ulcers, heavy menstrual bleeding, or frequent blood donations. Increased red blood cell breakdown can be seen in conditions like hemolytic anemias.

Hemochromatosis: Hemosiderin staining is a hallmark of hemochromatosis, a genetic disorder characterized by excessive iron absorption and deposition in tissues. In hemochromatosis, iron accumulates not only as hemosiderin but also as ferritin and free iron, leading to potential damage to various organs.

Venous Insufficiency: In the context of venous insufficiency, blood can pool in the lower extremities due to weakened veins. This can lead to leakage of red blood cells into surrounding tissues, followed by the breakdown of hemoglobin and the accumulation of hemosiderin. This process can result in brownish discoloration of the skin, particularly around the ankles.

Skin Discoloration: Hemosiderin staining can also be seen in skin conditions such as purpura or ecchymosis (bruising) that involve the leakage of blood into the skin tissue. Over time, the breakdown of the blood cells and deposition of hemosiderin can result in a characteristic brownish discoloration.

Additional Sources:

UCLA Health: https://www.uclahealth.org/news/hemosiderin-staining-product-trauma-or-venous-insufficiency#:~:text=Hemosiderin%20staining%20occurs%20when%20the,these%20is%20chronic%20venous%20insufficiency.

Healthline: https://www.healthline.com/health/hemosiderin-staining