Differentiating lipedema and Dercum’s disease

Beltrán, Karen Guzmán; Herbst, Karen L.

doi:10.1038/ijo.2016.205

Cited by 52 publications

(59 citation statements)

References 24 publications

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“…Low prevalence of diabetes has also been described in patients suffering from lipedema despite an average BMI of 39 ± 12 kg/m 2 (70). Additionally, a recent study on 46 affected patients found that the majority of them had a normal lipid profile, while only 11.7% had total cholesterol ≥ 240 mg/dL (18), compared with higher percentages (up to 33.5%) in the general female population.…”

Section: Clinical Trials and Investigationsmentioning

confidence: 96%

Lipedema: A Call to Action!

Buso

Depairon

Tomson

et al. 2019

Obesity

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Lipedema is a chronic progressive disease characterized by abnormal fat distribution resulting in disproportionate, painful limbs. It almost exclusively affects women, leading to considerable disability, daily functioning impairment, and psychosocial distress. Literature shows both scarce and conflicting data regarding its prevalence. Lipedema has been considered a rare entity by several authors, though it may be a far more frequent condition than thought. Despite the clinical impact on women's health, lipedema is in fact mostly unknown, underdiagnosed, and too often misdiagnosed with other similarly presenting diseases. Polygenic susceptibility combined with hormonal, microvascular, and lymphatic disorders may be partly responsible for its development. Furthermore, consistent information on lipedema pathophysiology is still lacking, and an etiological treatment is not yet available. Weight loss measures exhibit minimal effect on the abnormal body fat distribution, resulting in eating disorders, increased obesity risk, depression, and other psychological complaints. Surgical techniques, such as liposuction and excisional lipectomy, represent therapeutic options in selected cases. This review aims to outline current evidence regarding lipedema epidemiology, pathophysiology, clinical presentation, differential diagnosis, and management. Increased awareness and a better understanding of its clinical presentation and pathophysiology are warranted to enable clinicians to diagnose and treat affected patients at an earlier stage.

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Section: Clinical Trials and Investigationsmentioning

confidence: 96%

Lipedema: A Call to Action!

Buso

Depairon

Tomson

et al. 2019

Obesity

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show abstract

“…Stemmer sign, or the inability to pinch the base of the second toe, is a unique characteristic symptom for lymphoedema . In contrast to lipoedema, lymphoedema is not typically associated with easy bruising and tenderness; Table provides the differential diagnosis of lipoedema …”

Section: Diagnosis and Differential Diagnosismentioning

confidence: 99%

“…Patients with lipoedema had a significantly lower prevalence of type 2 diabetes and a higher prevalence of hypermobility. The location of fat, high average daily pain, presence of lipomas, and comorbid painful disorders help in the differentiation of DD from lipoedema …”

Section: Diagnosis and Differential Diagnosismentioning

confidence: 99%

“…29 In contrast to lipoedema, lymphoedema is not typically associated with easy bruising and tenderness; Table 2 provides the differential diagnosis of lipoedema. 30,31 DD is an uncommon painful lipodystrophy with autosomal-dominant inheritance that mainly involves postmenopausal females. DD can be further classified into nodular, diffuse, and mixed type.…”

Section: Diagnosis and Differential Diagnosismentioning

confidence: 99%

“…The location of fat, high average daily pain, presence of lipomas, and comorbid painful disorders help in the differentiation of DD from lipoedema. 31 We have established an algorithmic approach to guide clinicians towards the diagnosis of lipoedema. An algorithm for the diagnosis of lipoedema is given in Figure 3.…”

Section: Diagnosis and Differential Diagnosismentioning

confidence: 99%

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Lipoedema is not lymphoedema: A review of current literature

Shavit

Wollina

Alavi

2018

International Wound Journal

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Lipoedema is a rare painful disorder of the adipose tissue. It essentially affects females and is often misdiagnosed as lymphoedema or obesity. It is globally misdiagnosed or underdiagnosed, and the literature is lacking appropriate guidance to assist clinicians towards this diagnosis. However, the need to recognise this disorder as a unique entity has important implications to establish proper treatment and, therefore, its tremendous effect on patients. Early diagnosis and treatment can turn these patients' lives upside down. The aim of this review is to focus on the clinical guidance, differential diagnosis, and management strategies. In addition, other aspects of lipoedema, including epidemiology and pathogenesis, are also being discussed here. Lipoedema is distinct from obesity and distinct from lymphoedema, although it might progress to involve the venous and lymphatic system (venolipedema or lympholipedema or both). Late diagnosis can leave the patient debilitated. Management of lipoedema includes weight loss, control of oedema, complex decongestive physiotherapy, liposuction, and laser-assisted lipolysis. However; there are increasing reports on tumescent liposuction as the preferred surgical option with long-lasting results. The role of more randomised controlled studies to further explore the management of this clinical entity remains promising.

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Tissue Sodium Content is Elevated in the Skin and Subcutaneous Adipose Tissue in Women with Lipedema

Crescenzi

Marton

Donahue

et al. 2017

Obesity

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Objective To test the hypothesis that tissue sodium and adipose content are elevated in patients with lipedema; if confirmed, this could establish precedence for tissue sodium and adipose content representing a discriminatory biomarker for lipedema. Methods Participants with lipedema (n=10) and control (n=11) volunteers matched for biological sex, age, body-mass-index, and calf circumference were scanned noninvasively with 3.0T sodium and conventional proton MRI. Standardized tissue sodium content was quantified in skin, subcutaneous adipose tissue (SAT), and calf muscle. Dixon MRI was employed to quantify tissue fat and water volumes of the calf. Nonparametric statistical tests were applied to compare regional sodium content and fat-to-water volume ratio between groups (significance: two-sided p≤0.05). Results Skin (p=0.01) and SAT (p=0.04) sodium content were elevated in lipedema (skin: 14.9±2.9 mmol/L; SAT: 11.9±3.1 mmol/L) relative to control (skin: 11.9±2.0 mmol/L; SAT: 9.4±1.6 mmol/L) participants. Relative fat volume in the calf was elevated in lipedema (1.2±0.48 ratio) relative to control (0.63±0.26 ratio, p<0.001) participants. Skin sodium content was directly correlated with fat-to-water volume ratio (Spearman’s-rho=0.54, p=0.01). Conclusions Internal metrics of tissue sodium and adipose content are elevated in patients with lipedema potentially providing objective imaging-based biomarkers for differentially diagnosing the under-recognized condition of lipedema from obesity.

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Differentiating lipedema and Dercum’s disease

Cited by 52 publications

References 24 publications

Lipedema: A Call to Action!

Lipedema: A Call to Action!

Lipoedema is not lymphoedema: A review of current literature

Tissue Sodium Content is Elevated in the Skin and Subcutaneous Adipose Tissue in Women with Lipedema

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