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Lipoedema was first described by Allen and Hines (1940), and it is characterised by fat legs and orthostatic edema. Generalised obesity may be presend or absent, the mean weight of five illustrative patients in their paper ws 154.5 lbs. Allen and his co-workers (1951) then reported 119 cases of lipoedema at the Mayo Clinic from 1937 to 1946. The condition affects women almost exclusively. Hines (1952) states that the diagnosis of lipoedema can be made easily from observation: (1) The characteristic symmetrical distribution of fat in the lower half of the body, excepting the feet, and (2) the oedema of varying degrees in the more dependent portions of the legs. The condition is briefly mentioned by Martin et al. (1956). The condition is often confused with vascular diseases affecting lower extremities, and lymphoedema (Wold et al., 1951). Furthermore, these workers consider that lipoedema can be distinguished from lipodystrophy progressiva by the extensive loss of subcutaneous fat in the upper half of the body associated with deposition of fat in the buttocks and lower extremities (Whittle, 1944). Two patients are presented with lipoedema, associated with diabetes mellitus. The possibility that lipoedema may be a variatn of lipodystrophy progressive is discussed.

1. Lipoedema is described with an illustration of a recent case. 2. This condition should be distinguished from lymphoedema of the legs. 3. The differential diagnosis is discussed. 4. Comment is made on treatment.

En último término, el edema de los miembros se produce siempre a través de perturbaciones circulatorias. Estas alteraciones pueden tener un origen central o sistémico: afecciones cardiovasculares, renales, tiroideas o humorales (hipoproteinemia) y pueden también tener un origen periférico: insuficiencia venosa, linfoedema, etc. Uno de los problemas más difíciles de controlar para el médico es el edema de las piernas, de origen periférico, esto es sin relación con alteraciones cardiorrenales, tiroideas o humorales,. en otras palabras el edema consecutivo a la insuficiencia venosa que sucede como grave secuela a las flebotrombosis o flebitis, al linfoedema, etc. En los últimos años se ha avanzado bastante, sin embargo, en la prevención y en el tratamiento de estos edemas de origen periférico merced al mejor conocimiento de la fisiopatología, lo que supone un perfeccionamiento diagnóstico y a favor del uso de nuevos medios de tratamiento como ,los anticoagulantes y las vendas elásticas. Uno de los aportes más interesantes que se han hecho en el diagnóstico y diferenciación de estos sindromes es la descripción de una entidad clínica, hecha en Marzo de 1940 por dos investigadores de la Clínica Mayo: Allen y Hines que denominaron lipoedema de las piernas. Se trata de un aumento de volumen simétrico y generalizado de las piernas por aumento de los depósitos adiposos subcutáneos y por edema, que afecta casi exclusivameñte a las mujeres. A la descripción del cuadro clínico hecha en 1940 hemos sumado como antecedente bibliográfico un trabajo de conjunto que nos ha enviado directamente el Dr. Edgar v. Allen desde la Clínica Mayo, que no se ha publicado aún, y que reúne la experiencia de dicho servicio desde 1937 hasta 1946 .

« La parenté de l'ædeme chronique avec la lipomatose a depuis long lemps frappé les auteurs » ( 1 ) . Le cas actuel que nous publions aujourd'hui, après l'avoir présenté en quelques mots à la Société de Neurologie ( 2) , vient à l'appui de celle rollesion Ichard et L. Lévi. OBSERVATION ( PI. LXV ). Il s'agit d'une brodeuse de 39 ans, Mlle Eugénie B ... 1, venue à notre consul tation de l'hôpital Laënnec pour grosseur anormale des membres inférieurs . Antécédenis héréditaires -- La mère est morte à 25 ans, de tuberculose aiguë (alcoolisme possible). Son père est mort à 56 ans, très probablement d'un cancer du pylore. Eugénie B ... a une scur âgée de 41 ans, bien portante. Une de ses tantes aurait eu , pendant longtemps, de la difficulté à marcher . Antécédents personnels. -- Mile B ... n'a jamais été malade. Elle se souvient que, vers l'âge de 8 ans, elle avait déjà de gros mollets qui faisaient l'admira tion de ses camarades ; néanmoins, en promenade, elle se fatiguait plus vite que ses compagnes. Elle n'a jamais ressenti de douleurs vives dans les mem bres inférieurs. A 14 ans ses règles apparaissent régulières, avec un peu de dysmenorrhée. A 22 ans,, elle s'aperçoit que, sans aucun doute, ses jambes grossissent et non le reste du corps . L'ordème aurait envahi, par étapes, les jambes, les cuisses et les fesses . Elle est examinée et traitée à Lille , à Amiens et à Paris. A Lille elle prend de la tyroïdine ( 2 pilules par jour) , et de l'iode , pendant 15 jours . Elle maigrit sous l'influence de ce traitement.

Introduction. Personal observations (20 cases, 19 photographs). Consideration of special clinical varieties or syndromes—groups of cases. Group I. Adiposis dolorosa. Group II. Obesity. Group III. Nodular circumscribed lipomatosis. Group IV. Diffuse symmetrical lipomatosis (Fetthals, Madelung; adéno-lipomatose symétrique à prédominance cervicale, Launois and Bensaude). Group V. Neuropathic edema, pseudoedema, pseudolipoma and lipoma. Group VI. Adipositas cerebralis (Fröhlich, Madelung and others). Consideration of the combined groups. General summary (including special subjects, arthritism, heredity, etc.). Etiology (including glands of internal secretion). Treatment. Conclusions. Bibliography.The object of this study is to simplify or unify the clinical classification of abnormal subcutaneous fat deposits by correlating the symptomatology and constitutional relations common to the several varieties or clinical groups that have been separated under descriptive designations according to their predominant characteristics. It is with special reference to Dercum's ``adiposis dolorosa'' that this study is undertaken. I shall

Issuu is a digital publishing platform that makes it simple to publish magazines, catalogs, newspapers, books, and more online. Easily share your publications and get them in front of Issuu’s millions of monthly readers. Title: 2022 Report of the International Lipoedema Association Diagnosis Working Group, Author: Canadian Lymphedema Framework, Length: 15 pages, Page: 1, Published: 2023-10-25

<p>INTRODUCTION: Lipedema is a progressive connective tissue disease with enlargement of adipose tissue, fibrosis, fluid collection and dermal thickening. Herein, we present a case of lipedema associated with skin hypoperfusion and ulceration in which soft tissue debulking with liposuction improved patients’ symptoms. CASE PRESENTATION: A 39-year-old female presented with asymmetric progressive initially unilateral lower limb swelling with severe pain with subsequent skin ulceration. Conservative management have failed to improve her condition. After excluding other causes and detailed radiologic investigation, lipedema was diagnosed with an associated impaired skin perfusion. Trial of local wound care and compression therapy failed to improve the condition. Subsequent soft tissue debulking with circumferential liposuction and ulcer debridement and immediate compression showed dramatic improvement of the symptoms and skin perfusion. DISCUSSION: The unique nature of this case shed light on lipedema as a loose connective tissue disease. Inflammation and microangiopathies explains the associated pain with hypoperfusion and ulceration being quite atypical and in part might be related to the large buildups of matrix proteins and sodium contents leading to micro-vessels fragility with frequent petechiae and hematoma and subsequent tissue ischemia. Conservative measures like compression therapy plays a significant role in disease course. Surgical debulking with liposuction was shown to be efficacious in reducing the soft tissue load with improvement in limb pain, edema, circumference and skin perfusion that was seen in our patient. CONCLUSION: Lipedema is a frequently misdiagnosed condition with disabling features. Skin involvement in lipedema with potential hypoperfusion was shown and it requires further investigation</p>