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  • Wienert, V., & Leeman, S. (1991). [Lipedema]. Der Hautarzt; Zeitschrift Fur Dermatologie, Venerologie, Und Verwandte Gebiete, 42(8), 484–486.

    Lipodystrophy, almost exclusively seen in female patients, causes psychological problems at an early age. In later life, additional complaints are heavy painful legs, edema, and varicose veins. Nearly all patients suffer from alimentary adiposity. Dermolipectomies in general are not advisable because of the resulting large scars and the risk of damaging the lymphatic system. Subcutaneous lipectomy according to the Illouz method can provide good results. Weight loss is a good alternative to liposuction of the upper legs. After sufficient weight loss, only additional liposuction of the trochanteric area and the medial side of the knee is needed. No unpleasant scarring of the leg results. Unfortunately, older patients often require a skin reduction. The results of surgery in the lower legs were, except in 2 patients, good to excellent. The results in the upper legs were disappointing because 9 of 11 patients gained weight again after surgery. Considering this, the preferable treatment now is liposuction of the lower legs, medial side of the knee, and the txochanteric area. Only in cases of ptotic skin on the medial side of the upper legs is skin reduction without lipectomy indicated. Lipodystrophy suggests a disappearance of the subcutaneous fat. When this occurs in the upper part of the body, it is called progressive lipodystrophy. Lipodystrophy is known as an abnormality of the lower half of the female body, swollen by deposition of subcutaneous fat and determined by heredity. It occurs more frequently in the lower social classes and is often accompanied by an alimentary obesity, which is a psychological reaction to the disturbed body image. Nearly all patients have severe feelings of inferiority because people mock and laugh at them; thus, the alimentary component of the obesity is a form of compensation for lack of love. By dieting, the adiposity disappears only partly because the typical deformity of lipodystrophy remains. I believe that in the lipodystrophy patient a lipedema may develop resulting from lymphatic and venous disease, which may arise later in life. Younger patients' complaints are mainly psychological and result from a disturbed body image, whereas older patients are troubled by pain and leg weariness. Treatment consists of dieting, subcutaneous lipectomy by liposuction, and prescription of elastic stockings.

  • Bilancini, S., Lucchi, M., & Tucci, S. (1990). [Lipedema: clinical and diagnostic criteria]. Angiologia, 42(4), 133–137.

    Lipedema is a common disease in the usual clinical practice. None organic description about the clinical symptoms and signs associated to this condition has been published. Fifty women with lipedema have been examined by the authors, and incidence rates of symptoms and signs have been emphasized. The following signs and symptoms were constantly reported: "Egyptian column", elastic edema, negative Stemmer's sign, alterated plantar support, cutaneous hypothermia. Some others were frequently found: ecchymosis, spontaneous pain, liposclerosis on the thigh, hypodermic hyperalgesia and pain on the internal face of the knee. Moreover, the two most relevant differential diagnosis as well as their two variant's clinical features (mixed lipedema and "thin women" lipedema) have been described.

  • Ludwig, M., & Vetter, H. (1989). [Diagnosis and differential diagnosis of swollen leg]. Schweizerische Rundschau fur Medizin Praxis = Revue suisse de medecine Praxis, 78(37), 987–992.

    Leg swelling is often of edematous nature. The most important differential diagnosis lies in the distinction between venous or lymphatic forms of edema. An increased vascular permeability and alterations in blood composition have also to be taken into account. A particular entity is the lipedema. Next to an accurate history, specific inspection and palpatory criteria permit to distinguish the various forms. Tests for venous function, laboratory and technologically investigative techniques increase diagnostic accuracy. Lymphedema can only be diagnosed by an exact clinical diagnosis.

  • Wold, L. E., Hines, E. A. J., & Allen, E. V. (1951). Lipedema of the legs; a syndrome characterized by fat legs and edema. Annals of Internal Medicine, 34(5), 1243–1250. https://doi.org/10.7326/0003-4819-34-5-1243
  • Allen, E., & Hines, E. (1940). Lipedema of the legs: a syndrome characterized by fat legs and orthostatic edema. Proc Staff Meet Mayo Clin, 15, 184–187.
  • Lyon, I. P. (1910). ADIPOSIS AND LIPOMATOSIS: CONSIDERED IN REFERENCE TO THEIR CONSTITUTIONAL RELATIONS AND SYMPTOMATOLOGY. Archives of Internal Medicine, VI(1), 28–120. https://doi.org/10.1001/archinte.1910.00050290033005

    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

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