What is lipedema?
Due to fat accumulation under the skin, the illness known as lipedema, which primarily affects women, causes symmetrical swelling in the arms, legs, thighs, and buttocks. In guys, it is unusual. It may cause excruciating discomfort. There may be tenderness in the affected areas, and people generally bruise readily. Lymphoedema, a medical disorder caused by fluid retention in the affected areas over time, can develop as a result of lipedema.
Lipedema
Although it has not been proven, it is believed that lipedema may have a hereditary foundation because in certain cases the ailment runs in families. Sometimes it is considered to be excessive cellulite, weight gain, obesity, or lymphedema.
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History
Although first identified in the United States, at the Mayo Clinic in 1940, lipedema is barely known in that country – to physicians or to the patients who have the disease. It often is confused with obesity, and a significant number of patients currently diagnosed as obese are believed to have lipedema, either instead of or in addition to obesity.
The word lipedema has multiple spellings. Lipedema is the American spelling, while lipedema is used in Britain, Australia, and Europe. Lipodema is also used occasionally.
Epidemiology
Although there is no epidemiological data on the prevalence of lipedema, Földi described a prevalence of 11% in women, is extremely rare in men. Herpertz reports that it accounted for 15% of patients in a lymphedema clinic. A recent study reports that 6.5% of the children with the referral diagnosis of lymphedema actually suffer from lipedema.
Causes of Lipedema
The cause of lipedema isn’t known, but in some cases, there’s a family history of the condition. It seems likely that the genes you inherit from your parents play a role.
It tends to start at puberty or at other times of hormonal change, such during pregnancy or the menopause, which suggests hormones may also have an influence.
Although the accumulation of fat cells is often worse in obese people, it isn’t caused by obesity and can affect people who are a healthy weight. It shouldn’t be mistaken for obesity, and dieting often makes little difference to the condition.
Symptoms
The legs are enlarged bilaterally arms too can be affected
The waist is small in proportion to thighs, buttocks, and legs
Feet and hands are exempt and a ‘bracelet’ effect can appear just above the ankles and wrists
Legs/arms can be extremely painful, even to touch
Affected limbs bruise easily
The fat is soft to touch and wobbly, while skin can be cold to touch
It can become worse in hot weather
Diet and exercise, while important, can have minimal effect
Increase in Lipedema is often noticed when significant hormonal changes happen
Skin can have a cellulite like an appearance.
Complications of Lipedema
Lipedema can be tender and painful, and easy bruising occurs due to capillary weakness. In time, it can be complicated by lymphoedema; the combination of lipedema and lymphatic insufficiency is called lipo-lymphoedema or lymph-lipedema. Lymphoedema can result in warty papules, exudation of lymph, dermatitis and other complications. Increasing weight of the lower limbs can lead to orthopedic problems.
Diagnosis and test
Lipedema is diagnosed by its clinical features. It fails to improve on compression if this is used following a misdiagnosis of lymphoedema, in which swelling is due to the accumulation of lymph, a protein-rich fluid. However, lymphoedema may also develop within longstanding lipedema (lipo-lymphoedema). This is recognized by the development of irregular lumps, and progression of swelling to involve the feet.
It should be distinguished from simple obesity, which affects the whole body, and Dercum disease, which occurs at a later age and is due to lipoma deposition on trunk and limbs.
These are not usually necessary.
Ultrasound examination of may show normal dermis, and thickened subcutis with increased echogenicity. In contrast, lymphoedema has increased dermal thickness and decreased echogenicity.
CT scan shows thickened skin alone in lipedema, and fluid accumulation, honeycomb pattern and muscle enlargement in lymphoedema.
MRI is sometimes used to evaluate lymphatic circulation.
Treatment and medications
Dieting and exercising will not reduce the fat involved in lipedema. But it’s still important to do those things because they can help you lose weight from lipedema fat and reduce inflammation. A treatment called complete decongestive therapy can ease painful symptoms. Complete decongestive therapy involves:
Manual lymphatic drainage: A form of massage that uses gentle, rhythmic pumping movements to stimulate the flow of lymph around blocked areas to healthy vessels, where it can drain into the venous system. This helps relieve pain and prevent fibrosis.
Compression: The use of stretch bandages or custom-fitted pantyhose, panties, or spandex shorts to increase tissue pressure in the swollen legs and lessen the odds of fluid building up again.
Exercise: Helps to reduce fluid build-up, boost mobility, and maintain or improve how well your legs work.
Thorough skin and nail care: Helps lower the risk of wounds and infection if you have lipedema associated with swelling.
The lipedema fat can be eliminated via liposuction, particularly tumescent liposuction and water-assisted liposuction. In order to suction the fat tissue, a hollow tube is inserted beneath the skin. Depending on the amount of aberrant fat, multiple treatments can be required.
Keeping lipedema at bay
Lipedema cannot currently be prevented. Some medical procedures, both surgical and conservative, may occasionally assist some patients in delaying or preventing symptom progression. It is feasible to prevent a major expansion of lipedematous fat cells and to inform patients of their increased risk factors so they can take appropriate action if it is discovered early, which is currently exceedingly uncommon.
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