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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.

« 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>

Lymph node (LN) lipomatosis is a common but rarely discussed phenomenon associated with aging that involves a gradual exchange of the LN parenchyma into adipose tissue. The mechanisms behind these changes and the effects on the LN are unknown. We show that LN lipomatosis starts in the medullary regions of the human LN and link the initiation of lipomatosis to transdifferentiation of LN fibroblasts into adipocytes. The latter is associated with a downregulation of lymphotoxin beta expression. We also show that isolated medullary and CD34+ fibroblasts, in contrast to the reticular cells of the T-cell zone, display an inherently higher sensitivity for adipogenesis. Progression of lipomatosis leads to a gradual loss of the medullary lymphatic network, but at later stages, collecting-like lymphatic vessels are found inside the adipose tissue. The stromal dysregulation includes a dramatic remodeling and dilation of the high endothelial venules associated with reduced density of naïve T-cells. Abnormal clustering of plasma cells is also observed. Thus, LN lipomatosis causes widespread stromal dysfunction with consequences for the immune contexture of the human LN. Our data warrant an increased awareness of LN lipomatosis as a factor contributing to decreased immune functions in the elderly and in disease. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

Aim To explore the experiences of sexual health and intimate relationships in women with lipedema. Design A qualitative interview study. Methods Sixteen women with lipedema recruited from a national lipedema association group in Sweden participated. Data were collected between October 2023 and February 2024 and analysed using content analysis. Results Four main categories were identified. Being burdened by body shame highlighted the women's body dissatisfaction, difficulties in self-acceptance and shame when being naked in front of their partners. Being hindered by an aching and heavy body captured the experiences of bodily pain and heaviness in intimate situations. Being torn between desire and avoidance revealed that the women longed for intimacy but adopted different strategies to avoid it. Being affected by what is said and what is left unsaid showed the role of the partner's approach as well as the strain of not discussing sexual problems with partners or healthcare providers. Conclusion Women with lipedema experience physical, psychological and relational challenges in sexual life and intimacy. Still, these challenges remain unaddressed in healthcare settings. Implications for the Profession and Patient Care Nurses and midwives should, in their unique role in encountering women throughout their lifespans, address and invite dialogues on sexual-related concerns of women affected by lipedema. Impact The study findings provide insights into how lipedema affects women's sexual health and intimate relationships and offer new knowledge that can be applied when planning targeted interventions to promote the sexual health and well-being of women with lipedema. Reporting Method Adherence to the EQUATOR guidelines and COREQ checklist. Patient or Public Contribution Two patient representatives from a lipedema association group contributed to this study by distributing study information to their members.

Background: Lipedema is a chronic disorder characterized by symmetrical and disproportionate fat accumulation, pain, and easy bruising, often resistant to conventional treatments. Functional dysmetria (FD), a maladaptive neuromotor response linked to epigenetic stress, has been proposed as a relevant contributor to pain in lipedema., Objective: This retrospective observational study aimed to evaluate whether correcting FD through the radioelectric asymmetric conveyer (REAC) technology Neuropostural Optimization (NPO) protocol can reduce pain in patients with lipedema, using a sham-controlled design., Methods: In this retrospective observational study, 83 consecutive women with stage 2-5 lipedema underwent both sham and real NPO procedures during a single session. Pain intensity was measured using the visual analog scale (VAS) immediately after each procedure. Statistical analyses were performed using paired t-tests with effect sizes (Cohen’s dz) and 95% confidence intervals., Results: Baseline pain was uniformly high (mean 7.41 ± 0.53), with some pre-sham values reaching 10/10. Pain reduction was observed exclusively after real NPO and not after sham. Sham NPO induced no significant changes, whereas real NPO yielded a mean pain reduction exceeding 3.5 VAS points across all stages (mean change -3.65 ± 0.62; 95% CI: -3.79 to -3.51; Cohen’s dz = 5.88, 95% CI: 4.85-6.92; p < 0.0001)., Conclusions: These findings suggest that correction of FD by REAC NPO provides rapid and clinically meaningful analgesic effects in lipedema patients, addressing an upstream neuropsychomotor dysfunction that may contribute to disease progression. However, given the retrospective single-center design and absence of long-term follow-up, these conclusions are limited to the short-term effects observed. Further multicenter and longitudinal studies are warranted to confirm these results and evaluate long-term outcomes.

Health insurance companies are using plastic surgery stigma to deny medically-necessary treatment of lipedema. A closer look reveals greater ills within US healthcare.