lipedema

Etiology

• idiopathic

Epidemiology

• 10% of middle-aged women

Pathology

• increase in adipose tissue mass causes pain upon touch, when walking or exercising, progressively worsening over time, resulting in permanent damage to the lymphatic system & circulatory system

Clinical manifestations

• symmetric nonpitting fat deposition in buttocks & legs
• no edema in feet
  • cuff sign or fat pad of lipedema at the ankle
• disproportionate accumulation of fat in the extremities, usually the lower limbs but also in the upper limbs
• increased sensitivity to touch or pain with digital pressure
• easy bruising due to increased capillary fragility
• usually starts at puberty

Management

• lifestyle may play a role in controlling symptoms
  • an anti-inflammatory diet may be of benefit
  • a Mediterranean diet may be beneficial
  • a sedentary lifestyle or poor diet may exacerbate symptoms
• compression can reduce the pain and discomfort of affected limbs
• aquatic physical activity especially beneficial because water pressure promotes lymphatic drainage & buoyancy reduces load on the joints of lower limbs
• complex decongestive lymphatic therapy
  • manual lymphatic drainage with multilayered & multicomponent compression bandaging & physical exercise
• lymphatic drainage techniques,
• pressure therapy
• VASER liposuction

More general terms

• non-pitting edema