Lipedema is a disorder where there is enlargement of both legs due to deposits of fat under the skin. Typically it gets worse over time, pain may be present, and sufferers bruise easily. In severe cases the trunk and upper body may be involved. Lipedema is commonly misdiagnosed.
The cause is unknown but is believed to involve genetics and hormonal factors. It often runs in families. Risk factors include being overweight or obese. Other conditions that may present similarly include obesity, lipohypertrophy, chronic venous insufficiency, and lymphedema.
A number of treatments may be useful including physiotherapy and exercise. Physiotherapy may help to preserve mobility for a little longer than would otherwise be the case. Exercise, only as much as the patient is able to do without causing damage to the joints, may help with overall fitness but will not prevent progression of the disease. While surgery can remove fat tissue it can also damage lymphatic vessels. Treatment does not typically result in complete resolution. It is estimated to affect up to 11% of women. Onset is typically during puberty, pregnancy, or menopause.
Video Lipedema
Diagnosis
Differential diagnosis
Lymphedema
Lipedema can be underdiagnosed due the difficulty in differentiating it from other edemas and obesity, or clinicians failing to make themselves aware of the disease. Trayes 2013 published some tools including tables and a flow chart that can be used to diagnose lipedema and other edemas.
Lipedema / Dercum's Disease Differentiation These conditions may co-exist. Dercum's Disease is characterized by painful lipomas around the body.
Maps Lipedema
Treatment
A number of treatments may be useful including physiotherapy and light exercise which does not put undue stress on the lymphatic system. While surgery can remove fat tissue it can also damage lymphatic vessels. Treatment does not typically result in complete resolution.
The use of surgery to treat the condition is controversial. Options include liposuction and lipectomy.
The studies of highest quality involve tumescent or super tumescent anesthesia and vibrating liposuction, powered, cannula used with lymph sparing techniques. The treatment of lipedema with tumescent liposuction requires multiple procedures. In the United States Health Insurance do not generally pay for liposuction for lipedema, making it expensive. Liposuction under general anesthesia, without tumescent anesthesia, can be damaging and is not recommended for the treatment.
Prognosis
Complications include depression, anxiety, and pain.
Epidemiology
Estimates of the incidence of lipedema vary widely, and range as high as 11% of the post-pubertal female population, with estimates of 17 million women in the US, and 370 million women worldwide affected. "11% of adult women" is often cited but that is unsubstantiated.
History
Although first identified in the United States, at the Mayo Clinic in 1940, lipedema is barely known in that country - to physicians or to the patients who have the disease. Lipedema often is confused with obesity, and a significant number of patients currently diagnosed as obese are believed to have lipedema, either instead of or in addition to obesity.
See also
- Lymphedema
- Steatopygia
- Adiposis dolorosa
- Lipodystrophy
References
External links
Source of article : Wikipedia
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