Ann Rehabil Med.  2011 Dec;35(6):922-927. 10.5535/arm.2011.35.6.922.

Lipedema, a Rare Disease

• Shin BW
• Sim YJ
• Jeong HJ
• Kim GC

• KMID: 2266819
• DOI: http://doi.org/10.5535/arm.2011.35.6.922

Abstract

Lipedema is a chronic disease of lipid metabolism that results in the symmetrical impairment of fatty tissue distribution and storage combined with the hyperplasia of individual fat cells. Lipedema occurs almost exclusively in women and is usually associated with a family history and characteristic features. It can be diagnosed based on clinical history and physical examination. Lipedema is usually symmetrical, but spares the feet, is often painful to palpation, and is negative for Stemmer's sign. Additionally, lipedema patients can present with microangiopathies and lipomas. The well-known therapies for lipedema include complex decongestive therapy, pneumatic compression, and diet modifications. However, whether these treatments help reduce swelling is debatable. We encountered a case of lipedema that was initially misdiagnosed as lymphedema. The patient's clinical features and history were different from those typical of lymphedema, prompting a diagnosis of lipedema and she was treated with a complex decongestive therapy program.

Keyword

Lipedema; Lymphedema; Complex decongestive therapy

MeSH Terms

Adipocytes
Adipose Tissue
Chronic Disease
Female
Food Habits
Foot
Humans
Hyperplasia
Lipid Metabolism
Lipoma
Lymphedema
Palpation
Physical Examination
Rare Diseases

Figure

• 

  Fig. 1 Photograph of both lower limbs of the patient. Swelling is seen in both lower limbs except for the feet.

• 

  Fig. 2 Photograph of the patient's right lateral thigh. Multiple micropetechiae are seen on the right lateral thigh and calf.

• 

  Fig. 3 Results of Technetium-99m human serum albumin lymphoscintigraphy. (A) Lower extremity Technetium-99m human serum albumin lymphoscintigraphy obtained 30 minutes after the injection of radionuclides revealing normal lymphatic drainage. (B) Lower extremity Technetium-99m human serum albumin lymphoscintigraphy obtained three hours after the injection of radionuclides revealing normal lymphatic drainage.

Reference

1. Weisseleder H, Schuchhardt C. Lymphedema diagnosis and therapy. 2008. 4th ed. Germany: Viavital;p. 294–323.

2. Child AH, Gordon KD, Sharpe P, Brice G, Ostergaard P, Jeffery S, Mortimer PS. Lipedema: an inherited condition. Am J Med Genet A. 2010; 152A:970–976. PMID: 20358611.

3. Juther JE. Lymphedema management: the comprehensive guide for practitioners. 2005. 1st ed. New York: Thieme;p. 87–89.

4. Földi E, Földi M, Ströβenreuther R, Kubik S. Textbook of lymphology for physicians and lymphedema therapists. 2006. 2nd ed. Munchen: URBAN & FISCHER;p. 396–403.

5. Pascucci A, Lynch PJ. Lipedema with multiple lipomas. Dermatol Online J. 2010; 16:4–9. PMID: 20875325.

6. Szolnoky G, Nagy N, Kovacs RK, Dosa-Racz E, Szabo A, Barsony K, Balogh M, Kemeny L. Complex decongestive physiotherapy decreases capillary fragility in lipedema. Lymphology. 2008; 41:161–166. PMID: 19306662.

7. Rudkin GH, Miller TA. Lipedema: a clinical entity distinct from lymphedema. Plast Reconstr Surg. 1994; 94:841–847. PMID: 7972431.

8. Szolnoky G, Borsos B, Barsony K, Balogh M, Kemeny L. Complete docongestive physiotherapy with and without pneumatic compression for threatment of lipedema: a pilot study. Lymphology. 2008; 41:40–44. PMID: 18581957.

9. Macdonald JM, Sims N, Mayrovitz HN. Lymphedema, lipedema, and the open wound: the role of compression therapy. Surg Clin North Am. 2003; 83:639–658. PMID: 12822730.