Sclerosing panniculitis is a chronic panniculitis characterized by skin induration and hyperpigmentation of one or both legs that often occurs in patients who have venous insufficiency. The indurated plaques are often painful and the legs frequently have a characteristic “inverted wine bottle” appearance. Histopathology is characterized by mostly lobular panniculitis with necrosis of fat and without vasculitis, and in fully developed lesions by septal sclerosis and membranocystic changes. Treatment of sclerosing panniculitis includes compression therapy with graded stockings and anabolic steroids.