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Lipedema


Presentation

  • This tumefactive presentation of lipedema has not been previously described.[ncbi.nlm.nih.gov]
  • The patients suffering from lipedema showed an abnormal lymphoscintigraphic pattern with a slowing of the lymphatic flow that presented some analogies to the alterations found in the patients suffering from lymphedema.[ncbi.nlm.nih.gov]
  • The present, revised guidelines on lipedema were developed under the auspices of and funded by the German Society of Phlebology (DGP).[ncbi.nlm.nih.gov]
  • Two cases of lipedema are presented. They illustrate this clinical syndrome which occurs almost exclusively in women and presents as grossly enlarged legs, thighs and buttocks. The etiology remains uncertain.[ncbi.nlm.nih.gov]
  • We present a case of rapid accumulation of edematous adipose tissue causing cauda equina syndrome after a lumbar decompression and fusion surgery.[ncbi.nlm.nih.gov]
Pain
  • Pain was evaluated with a 10-item questionnaire, a pain rating scale (PRS), and the Wong-Baker Faces scale. Treatment resulted in a significant reduction of pain with a decrease in mean scores of all three measures.[ncbi.nlm.nih.gov]
  • Abstract Background Lipedema is a common painful subcutaneous adipose tissue (SAT) disorder in women affecting the limbs. SAT therapy is a manual therapy to improve soft tissue quality.[ncbi.nlm.nih.gov]
  • The location of fat, high average daily pain, presence of lipomas and comorbid painful disorders in DD patients may help differentiate from lipedema.[ncbi.nlm.nih.gov]
  • BACKGROUND: Lipedema is a painful, genetically induced abnormal deposition of subcutaneous fat in the extremities of almost exclusively women. The pathogenesis is unknown and no curative treatment is available.[ncbi.nlm.nih.gov]
  • Results Lipedema is a foe because lifestyle change does not reduce lipedema fat, the fat is painful, can become obese, causes gait and joint abnormalities, fatigue, lymphedema and psychosocial distress.[ncbi.nlm.nih.gov]
Weight Gain
  • Although weight loss may not help, prevention of additional weight gain is important, as any weight gain to the affected body areas becomes difficult to treat. Emotional support is often overlooked.[journals.sagepub.com]
  • Lipedema is not caused by a weight gain due to overeating. In contrast, dieting does not help lipedema weight to be lost. Lipedema is not prone to the types of infections that are typical of lymphedema.[lymphnotes.com]
  • Individuals who suffer from the disease are further impacted by the absence of diagnostic tools, the lack of public and medical awareness of lipedema, and the stigma associated with weight gain.[philanthropy.milkeninstitute.org]
  • As I got older, I would experience bouts of weight gain over a very short amount of time. I would gain more than 20 lbs in a 2-3 week period and could never understand why.[gofundme.com]
Leg Swelling
  • In each group, the results were dismal as leg swelling worsened or was unchanged in greater than 90% whereas symptoms such as heaviness, fatigue, cramps (termed varicogenic symptomatology) were improved in less than 10%.[ncbi.nlm.nih.gov]
  • Keywords: lipedema, leg swelling, lipodystrophy, localized adiposity, lower extremity liposuction This work is published and licensed by Dove Medical Press Limited.[doi.org]
  • Symptoms include painful legs and symmetrical leg swelling ending abruptly just above the ankles, known as the ‘cut-off sign’, as seen in Figure 1 .[journals.sagepub.com]
Lymphedema of the Lower Extremity
  • Abstract In a review of 250 cases of lymphedema of the lower extremity, 9 patients were noted to share unique similarities in their history and physical findings.[ncbi.nlm.nih.gov]
  • The investigators will evaluate to what extent CDT with graded negative pressure impacts lymphatic functioning in patients with lipedema or lymphedema of the lower extremities.[clinicaltrials.gov]
  • Rudkin and Miller (1994) reviewed 250 cases of lymphedema of the lower extremity and identified 9 patients who shared unique findings in their histories and physical examination that were atypical for lymphedema, but rather representative of lipedema.[ncbi.nlm.nih.gov]
Lower Extremity Pain
  • In addition, motor nerve and sensory nerve conduction studies were performed to identify the cause of the lower extremity pain.[dx.doi.org]
  • extremity pain, loss of strength, and deconditioning; in more severe cases, lipedema can lead to deterioration in daily activity levels.[dovepress.com]
Venous Insufficiency of Leg
  • Kotaro Suehiro, Noriyasu Morikage, Osamu Yamashita, Makoto Samura, Yuya Tanaka, Yuriko Takeuchi, Kaori Nakamura and Kimikazu Hamano, Differentiation of functional venous insufficiency and leg lymphedema complicated by functional venous insufficiency using[doi.org]
Petechiae
  • Decongestive therapy resulted in a significant reduction of the number of petechiae while no change was detected within the control group.[ncbi.nlm.nih.gov]
  • Upon examination, petechiae were noted in both lower extremities and a lipoma was observed under the right knee joint ( Fig. 1, 2 ).[dx.doi.org]
Leg Pain
  • *Horse chestnut capsules relieve leg pain and swelling. *Bio-rutin improves circulation and keeps capillaries open. It also stops the bruising and bleeding so common with lipedema. *Cayenne Pepper will also stop the bleeding caused by lipedema.[alignlife.com]
  • 272.8 "lipomatosis" E65 "swelling" E88.2 "Lipomatosis, not elsewhere classified" Mesh DO65134 ORPHA 77243 OMIM 614103 Synonyms Lipalgia Adiposalgia/Adipoalgesia Adiposis dolorosa Lipomatosis dolorosa of the legs Lipohypertrophy dolorosa Painful column leg[fatdisorders.org]
Lip Edema
  • One unpublished epidemiologic study puts lip edema incidence in females at 11%. Some patients have a combination of lipedema and lymphedema. (See Viewing lipolymphedema .)[woundcareadvisor.com]
Dysesthesia
  • The pre/post-treatment VAS mean score changes were: heaviness from 4.57 3.46 to 2.43 2.57 (-47%), dysesthesias from 1.71 2.63 to 0.71 1.50 (-58%), pain from 1.57 2.57 to 0.57 0.79 (-64%).[ncbi.nlm.nih.gov]
  • Key signs and symptoms include: • feeling of heaviness in the legs (aching dysesthesia) • easy bruising • sensitivity to touch (called “painful fat syndrome”) • orthostatic edema • oatmeal-like changes to skin texture.[woundcareadvisor.com]
Radiculopathy
  • The patient was a 45-year-old woman with chronic back pain, worsening bilateral L5 radiculopathy, and degenerative disc disease.[ncbi.nlm.nih.gov]

Workup

  • Further diagnostic tests are usually reserved for special cases that require additional workup. Lipedema is a chronic, progressive disorder marked by the individual variability and unpredictability of its clinical course.[ncbi.nlm.nih.gov]
  • We can assess your circulation in our non-invasive cutting edge vascular lab as part of your workup to ensure that any issues with blood flow can be addressed, and it is part of your workup at our centers.[nycsurgical.net]
  • Consideration for the following differential diagnosis for lipedema can be helpful when embarking upon further workup to determine proper clinical management. Figure 3 Algorithm for workup in patients presenting with lower extremity enlargement.[dovepress.com]

Treatment

  • We therefore aimed to measure pain intensity prior and subsequent to treatment. 38 women with lipedema were enrolled in the study with 19 patients undergoing treatment and 19 serving as the control group using exclusively moisturizers.[ncbi.nlm.nih.gov]
  • Treatment is divided into conservative and chirurgic treatment. The only available technique to correct the abnormal adipose tissue is surgery.[ncbi.nlm.nih.gov]
  • OBJECTIVES: Patient-relevant treatment benefit is traditionally measured with health-related quality of life (HRQoL) instruments.[ncbi.nlm.nih.gov]
  • Abstract Lipedema is a disproportional obesity for which evidence-based treatment is not currently available.[ncbi.nlm.nih.gov]
  • RESULTS: All the patients completed the scheduled treatment. After the treatment the mean volume of the whole limb decreased from 9462.85 ( 3407.02) to 9297.37 cc ( 3393.20), which accounts for a 165.48 cc (2%) reduction after six days of treatment.[ncbi.nlm.nih.gov]

Prognosis

  • Obesity is an important risk factor for the severity and prognosis of lipedema. Further studies for a better understanding of the pathogenesis of lipedema and in the end possible curative treatments are urgently needed.[ncbi.nlm.nih.gov]
  • Active treatment for lipedema is required because early diagnosis and treatment can determine the patient's long-term prognosis.[dx.doi.org]
  • •Overview of lipedema written for clinicians •Includes History, Epimediology & Clinical Features, Etiology & Pathogenesis, Diagnosis and Treatment, and Prognosis •Written by credible experts in the field •eBooklet digital form, condensed and easy to[diseasetheycallfat.lipedemaproject.org]

Etiology

  • Lipedema is an underdiagnosed syndrome of unclear etiology, characterized by symmetric painful enlargement of the buttocks and lower extremities, which spares the feet. This enlargement is caused by the deposition of adipose tissue.[ncbi.nlm.nih.gov]
  • The etiology remains uncertain. Although infrequently diagnosed, lipedema is not rare. We report success treating such patients with properly measured and fitted compression garments.[ncbi.nlm.nih.gov]
  • Lipedema is a disease with unknown etiology presenting as bilateral and symmetric enlargement of the lower extremities due to subcutaneous deposition of the adipose tissue.[ncbi.nlm.nih.gov]
  • The etiology and pathogenesis of this disease are still the object of study, and therapy is very difficult. Various authors have described morphologic and functional alterations of prelymphatic structures and of lymphatic vessels.[ncbi.nlm.nih.gov]
  • Its etiology is unknown but in analogy to central obesity, chronic low-level inflammation in adipose tissue has been suggested.[ncbi.nlm.nih.gov]

Epidemiology

  • In this review, we sought to review and identify information in the existing literature with respect to the epidemiology, pathogenesis, clinical presentation, differential diagnosis, and management strategies for lipedema.[ncbi.nlm.nih.gov]
  • As a result, the true number of women with lipedema, or its epidemiology, is unknown. Braving these challenges is an active, numerous, and engaged patient community eager to participate in lipedema research.[philanthropy.milkeninstitute.org]
  • Most commonly used synonyms for lipedema include: Adiposalgia/Adipoalgesia Adiposis dolorosa Lipalgia Lipomatosis dolorosa of the legs Lipodystrophia dolorosa Painful column leg This condition almost exclusively affects women; according to an epidemiologic[lymphedemablog.com]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiological basis is edematization of the tissues. Lymphedema involves an impairment of lymph drainage with resultant fluid build-up.[ncbi.nlm.nih.gov]
  • To enhance the learner's competence in caring for patients with lipedema through understanding the differential diagnoses, pathophysiology, and treatment/management options.[ncbi.nlm.nih.gov]
  • Abstract PURPOSE: To enhance the learner's competence in caring for patients with lipedema through understanding the differential diagnoses, pathophysiology, and treatment/management options.[doi.org]
  • Szolnoky, Pathophysiological dilemmas of lipedema, Medical Hypotheses, 83, 5, (599), (2014). L.V. Zhuravlyova and A.A.[doi.org]
  • Lipedema pathophysiology (the way it happens) likely involves problems with the fat cells (adipocytes) themselves but also the lymphatic system, vascular system, hormonal influences, and inflammation, but more research is needed to better understand how[wholehealthllc.com]

Prevention

  • From these findings it is concluded, that a release of lipid peroxidation (LPO) products from edematous dermis is an important sclerosis-preventing effect of SWT and/or CPDT in lipedema and cellulite.[ncbi.nlm.nih.gov]
  • Tumescent liposuction is the most effective treatment for Lipedema, and it can prevent recurrence for an average of five years.[stanfordhealthcare.org]
  • Compression CAN help prevent disease progression. Since compression can help maintain smaller limb volume, and increased limb volume exacerbates the condition, it can be helpful in preventing lipedema progression.[torontophysiotherapy.ca]
  • A thorough understanding of the mechanisms of BMP-2 and specific guidelines for their role in spinal surgery may improve functional outcomes and reduce the number of preventable complications.[ncbi.nlm.nih.gov]
  • This blockage prevents the proper drainage of lymph fluid, leading to a buildup of fluid called lymphedema .[webmd.com]

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