Comment on “Lipoatrophia semicircularis – a distinct entity?”

"Semicircular Lipoatrophy of Occupational Origin (SLOO): Proposal of a Clinical History Sheet for Data Collection and Implementation of Corrective Factors"

“…In Spain, the first cases appeared in 2007, causing a health scare with great media coverage among the working population in Catalonia, and cases were subsequently reported in other autonomous communities [4]. Although there is insufficient scientific evidence on the causes, in the studies reviewed, it is associated with repeated microtrauma due to repeated pressure from office furniture, tight clothing, electromagnetic fields and static electricity (work environment factors such as low relative humidity and the influence of computer equipment and wiring) [5].…”

“…There is no specific treatment. The lesions reverse after elimination of the triggering factors [5,[8][9][10][11][12]:…”

Lipoatrophia Semicircularis

“…Some initial isolated reports were reasonably attributed to local trauma, such as the place of support on a thigh of a bucket for collecting vegetables [8], leaning against desks [9,10], ironing boards, bath's border for washing [11], dresser with mirror [12] or wash bowl while applying make-up [13][14][15], knocking against the edge of the laundry [16], resting against the counter [17], crossing legs beneath the office desk [18], wearing tight jeans, trousers (Figures 1 and 2) or girdle [11,[19][20][21][22], or hold-up stockings [23], frequent use of sports tights [24], elastic bands [25] or hosiery with an elastic component [18], or appearance of lesions some weeks after the introduction of a new chair at office work [26]. Interestingly, in the case described after wearing tight jeans [19], the same authors described identical lesions a year after in a sister of their initial patient, who developed them after wearing the discarded jeans [27].…”

“…When done, these have essentially shown a partial loss of fat, sometimes replaced by new collagen [30], and absence of panniculitis signs. In one case a nearly complete loss of adipose lobules was reported, without signs of inflammation or fibrosis [70]; other cases have shown loosely dispersed fat lobules with medium-sized adipocytes [14], decreased size of adipocytes with intermingled eosinophilic and hyaline material and some histiocyte and lymphocyte infiltration [20,40], mild accentuation of interlobular septa with atrophy and centrilobular fibrosis of some adipocytes without inflammation [23], hemorrhage in the fat tissue compatible with panniculitis [16], complete loss of adipose tissue [34] and involutional adipocytes, numerous capillaries, and a sparse lymphohistiocytic infiltrate with calcification [36].…”