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The aim of the current study was to alert about dermatological alterations in the clinical evolution of lipo-lymphedema. The case of a 48-year-old patient is reported with clinical diagnosis of stage II lipo-lymphedema treated in the Angiology and Vascular Surgery Service of FAMERP. On physical examination the edema was hard, not reversible during rest, with nodules in the lower one-third of the limbs and a positive Stemmer's sign. The sizes of the nodules were different between legs. This report stresses the clinical findings and the differences in each disease. Additionally a review of publications is presented. The dermatological changes occurring in the evolution of lipedema may be associated with the evolution of lipo-lymphedema.
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AIM: We evaluated the outcome and risks of tumescence liposuction in patients with advanced lipedema or Dercum's disease. METHODS: Six patients treated at a single center during the years 2004 to 2008 have been included. All patients were female and obese (body mass index 34 to 41.9; mean 38.2+/-3.8) with an age range from 29 to 78 years (mean 55.7+/-20.5 years), five of them had co-morbidities. RESULTS: The total amount of lipoaspirates varied between 1500 mL and 4800 mL. Pain could be reduced in all four patients with Dercum's disease. Large adipose tissue removing implies a better the outcome for pain. Patient's satisfaction was "high" or "very high" in 5 and "medium" in one. The most common adverse effect was met-hemoglobulinemia (N.=4). CONCLUSION: Tumescence liposuction is a treatment option for lipedema and Dercum's disease. With careful monitoring the procedure is safe even for patients in advanced stages, higher age and with co-morbidities.
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PURPOSE: To enhance the learner's competence in caring for patients with lipedema through understanding the differential diagnoses, pathophysiology, and treatment/management options. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES: After participating in this educational activity, the participant should be better able to: 1. Differentiate lipedema from other similar diagnoses. 2. Tell patients with lipedema and their caregivers about treatment of this condition. 3. Construct assessments, treatment plans, and management options for patients with lipedema.
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In the guidelines for lipedema treatment, in addition to decongestive therapy, surgical therapy (liposuction) is advised as a standard treatment. However, in most cases the German social health insurance system refuses to pay for the costs of treatment. While primarily medical arguments are cited, it is clear that this refusal is chiefly due to the socioeconomic restrictions in the German social health insurance system. At present objective criteria in the form of prioritization are being tested for evaluation and to create a ranking list for the validity of treatment. For liposuction it is not yet clear whether in addition to an improvement in the quality of life, a reduction in lifetime treatment costs can be achieved.
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- Lipedema (7)
- Original studies and data (1)
- Review (4)
- Therapeutics (1)
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- Journal Article (6)