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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
General
non-pitting edema
References
- Jimenez A
Lipedema: A Not-Uncommon Disease Still Goes Unrecognized
Medscape. Nov 17, 2022
https://www.medscape.com/viewarticle/984266