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Summary Lipedema is a painful, chronically progressive disease that is characterized by a symmetrical increase in subcutaneous fat with fluid accumulation on the legs and / or arms. Due to ignorance of the clinical picture, the disease is often not recognized or misinterpreted. Correct diagnosis and treatment are important, however, as the prognosis of the disease can be influenced. A causal therapy for lipedema is not known because the exact etiology is not yet fully understood. A hereditary component is suspected on the basis of a family history of the disease. Since lipedema occurs almost exclusively in women and the onset of the disease is often associated with the onset of hormonal changes (puberty, pregnancy, menopause), In addition, the estrogen is assigned a decisive role in the development. In the present work we present an overview of the symptoms and clinical features of lipedema, its differential diagnoses, treatment options and, lastly, the current hypotheses on the pathogenesis of lipedema.
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Lipedema is a frequently unrecognized and misdiagnosed disorder of the fatty tissue of extremities and hips, which affects almost purely women. The beginning of the disease usually occurs with hormonal changes, such as puberty, pregnancy, or menopause. Women suffer from pain, easy bruising, and disfigurement, which may lead to early immobility and social stress. Accurate diagnosis and treatment are essential. The differentiation between obesity and lipedema is difficult, as these two different entities often occur together. Other differential diagnoses are lymphedema, benign lipohypertrophy, and Dercum’s disease. A therapy targeting the underlying cause of lipedema is not available because the exact etiology of the disorder is not clarified yet. Decongestive physical therapy is the basic conservative treatment, which is usually necessary lifelong. However, liposuction has led to a paradigm shift in the treatment of lipedema. The purposes of this article are to describe the symptoms and treatment options of the still fairly unknown disease Lipedema and to show the distinctions to its differential diagnoses.
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Lipoedema is a painful, chronic progressive disorder of adipose tissue, characterised by symmetrical swelling of the lower and/or upper limbs. Due to a lack of awareness, lipoedema is frequently misdiagnosed. However, accurate diagnosis and treatment are essential since they determine the patient's prognosis. There is no known causal therapy because the exact aetiology of the disease is not fully understood at this time. Familial aggregation is common, which suggests a genetic disorder. Since lipoedema is almost exclusively found in women and manifests around hormonal changes (puberty, pregnancy, menopause), oestrogen is believed to play a decisive role in its pathogenesis. This review aims to summarise the symptoms and clinical features of lipoedema, its differential diagnosis, treatment options, and current theories on the pathogenesis of lipoedema.
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