The chronically swollen painful extremity. A detailed study for possible etiological factors

Stallworth, J. Manly

doi:10.1001/jama.228.13.1656

Cited by 12 publications

(17 citation statements)

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“…The gross description of the fat in lipedema is similar to that of MSL with "free fluid fat" in biopsy specimens [125] . Histological exam is not unlike that found for cellulite with dilation of subdermal blood capillaries, perivascular cells, fibrosis of arterioles, fibrosis and dilation of venules, and hypertrophy and hyperplasia of adipocytes [126,127] .…”

Section: Histology Of Lipedema Satmentioning

confidence: 79%

“…Large clusters of macrophages are found around multiple fat cells (not isolated crown-like structures [129] ), surrounding blood vessels and forming oil cysts in lipedema SAT [116,130] ; macrophages may also be a prominent component of cellulite [131] . The histology of lipedema SAT can also appear as normal [125] .…”

Section: Histology Of Lipedema Satmentioning

confidence: 99%

“…During this time, visualization of lymphatic vessels on a gross level by lymphoscintigraphy is normal [138,139] . As lipedema progresses, microaneurysms appear in the lymphatics in the skin [139,140] which eventually leak [125,136] . It is during this time that hypertrophy and hyperplasia of fat cells accelerates [138] further altering the microlymphatic architecture and increasing venous congestion.…”

Section: Physiology Of Lipedema Satmentioning

confidence: 99%

“…Other changes in skin include dryness, fungal infections, cellulitis, and slow wound healing. Free fatty acids may be different in both blood and the lipedema SAT [125] .…”

Section: Conditions Associated With Lipedemamentioning

confidence: 99%

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Rare adipose disorders (RADs) masquerading as obesity

2012

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Rare adipose disorders (RADs) including multiple symmetric lipomatosis (MSL), lipedema and Dercum's disease (DD) may be misdiagnosed as obesity. Lifestyle changes, such as reduced caloric intake and increased physical activity are standard care for obesity. Although lifestyle changes and bariatric surgery work effectively for the obesity component of RADs, these treatments do not routinely reduce the abnormal subcutaneous adipose tissue (SAT) of RADs. RAD SAT likely results from the growth of a brown stem cell population with secondary lymphatic dysfunction in MSL, or by primary vascular and lymphatic dysfunction in lipedema and DD. People with RADs do not lose SAT from caloric limitation and increased energy expenditure alone. In order to improve recognition of RADs apart from obesity, the diagnostic criteria, histology and pathophysiology of RADs are presented and contrasted to familial partial lipodystrophies, acquired partial lipodystrophies and obesity with which they may be confused. Treatment recommendations focus on evidencebased data and include lymphatic decongestive therapy, medications and supplements that support loss of RAD SAT. Associated RAD conditions including depression, anxiety and pain will improve as healthcare providers learn to identify and adopt alternative treatment regimens for the abnormal SAT component of RADs. Effective dietary and exercise regimens are needed in RAD populations to improve quality of life and construct advanced treatment regimens for future generations.

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Section: Histology Of Lipedema Satmentioning

confidence: 79%

Section: Histology Of Lipedema Satmentioning

confidence: 99%

Section: Physiology Of Lipedema Satmentioning

confidence: 99%

“…Other changes in skin include dryness, fungal infections, cellulitis, and slow wound healing. Free fatty acids may be different in both blood and the lipedema SAT [125] .…”

Section: Conditions Associated With Lipedemamentioning

confidence: 99%

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Rare adipose disorders (RADs) masquerading as obesity

2012

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“…Schmitz bezeichnet diese wenig geläufige Form der symmetrischen Beinschwellung als das "dicke Bein der gesunden Frau". Stallworth hat beim Lipödem eine regelrechte Funktion der Lymphgefäße, der Arterien und der Venen beobachtet [20]. Herpertz hingegen vermutet eine "leichte mechanische Abflußbehinde-rung der Lymphkapillaren, Präkollek-toren und Kollektoren durch den zunehmenden Druck des sich vermehrenden Fettgewebes" [9].…”

Section: Die Beteiligung Des Lymphgefäß-systems Beim Primär Nichtlympunclassified

Die Beteiligung des Lymphgefäßsystems beim primär nichtlymphogenen Ödem des Beines

Bräutigam

Vanscheidt

Földi³

et al. 1997

Der Hautarzt

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Two-compartment lymphoscintigraphy was developed to examine the sub- and epifascial lymphatics of the leg. Digital images were evaluated visually and semiquantitatively by calculating the uptake of activity within the lymph nodes. The data from patient groups with four different types of leg edema were compared with those of the control group to prove the involvement of the lymphatics in the non-lymphatic edema. The cyclic idiopathic edema demonstrated an accelerated transport of the lymph consistent with a high volume insufficiency. In phlebedema the high volume insufficiency was epifascially so distinct, that it could be detected scintigraphically. In post thrombotic syndrome the transport of the lymph was reduced dramatically corresponding to a safety valve insufficiency. Epifascially however, an accelerated lymph flow was observed due to compensatory mechanisms. The lipedema did not show any scintigraphic abnormalities. These results show that two-compartment lymphoscintigraphy can detect alterations in lymphatic function secondary to non-lymphogenic leg edema. The lymphatic function is changed according to the underlying pathophysiology which may be facilitate the differential diagnosis of such a leg edema.

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The nervous system and adipose tissue

Dalziel¹

1989

Clinics in Dermatology

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The chronically swollen painful extremity. A detailed study for possible etiological factors

Cited by 12 publications

References 0 publications

Rare adipose disorders (RADs) masquerading as obesity

Rare adipose disorders (RADs) masquerading as obesity

Die Beteiligung des Lymphgefäßsystems beim primär nichtlymphogenen Ödem des Beines

The nervous system and adipose tissue

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