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An approach to lipedema: a literature review of current knowledge of an underestimated health problem

  • Alper TuğralEmail author
  • Yeşim Bakar
Review
  • 43 Downloads

Abstract

Lipedema, which has been known as an adipose tissue disorder characterized by abnormal fat deposition, mostly affects women. This condition can easily be ruled out regarding its diagnosis because it is commonly misdiagnosed as obesity. True diagnosing and optimal management of lipedema show a great importance. As patients suffer from lipedema, not only experiencing physical symptoms such as tenderness or a feeling of heaviness but also psychological symptoms such as anxiety, they cause negative influences on quality of life of a person with lipedema. This paper tries to review all aspects of lipedema from diagnosis to management and assessment options.

Keywords

Lipedema Lymphedema Body weight Obesity 

Notes

Patient consent

Patients provided written consent for the use of their images.

Conflict of interest

Alper Tuğral and Yeşim Bakar declare that they have no conflict of interests.

Ethical approval

For this type of study, a formal consent from a local ethics committee is not required.

References

  1. 1.
    Child AH, Gordon KD, Sharpe P et al (2010) Lipedema: an inherited condition. Am J Med Genet Part A 152:970–976CrossRefGoogle Scholar
  2. 2.
    Herpertz U (1995) Das lipödem. Z Lymphol 19(1):1–11Google Scholar
  3. 3.
    Buck DW II, Herbst KL (2016) Lipedema: a relatively common disease with extremely common misconceptions. Plast Reconstr Surg Glob Open 4(9):e1403CrossRefGoogle Scholar
  4. 4.
    Földi MFE (2006) Földi’s Textbook of Lymphology. Mosby/Elsevier GmbH Münih, Munchen, GermanyGoogle Scholar
  5. 5.
    Herbst KL (2012) Rare adipose disorders (RADs) masquerading as obesity. Acta Pharmacol Sin 33:155–172CrossRefGoogle Scholar
  6. 6.
    Okhovat J-P, Alavi A (2015) Lipedema: a review of the literature. Int J Low Extrem Wounds 14:262–267CrossRefGoogle Scholar
  7. 7.
    Fife CE, Maus EA, Carter MJ (2010) Lipedema: a frequently misdiagnosed and misunderstood fatty deposition syndrome. Adv Skin Wound Care 23:81–92CrossRefGoogle Scholar
  8. 8.
    Szél E, Kemény L, Groma G, Szolnoky G (2014) Pathophysiological dilemmas of lipedema. Med Hypotheses 83:599–606CrossRefGoogle Scholar
  9. 9.
    Godoy MFG, Buzato E, Brigidio PAF et al (2012) Is lymphostasis an aggravant of lipedema. Case Rep Dermatol 4:222–226CrossRefGoogle Scholar
  10. 10.
    Suga H, Araki J, Aoi N, Kato H, Higashino T, Yoshimura K (2009) Adipose tissue remodeling in lipedema: adipocyte death and concurrent regeneration. J Cutan Pathol 36:1293–1298CrossRefGoogle Scholar
  11. 11.
    Mayes J, Watson G (2004) Direct effects of sex steroid hormones on adipose tissues and obesity. Obes Rev 5:197–216CrossRefGoogle Scholar
  12. 12.
    Gavin KM, Cooper EE, Hickner RC (2013) Estrogen receptor protein content is different in abdominal than gluteal subcutaneous adipose tissue of overweight-to-obese premenopausal women. Metabolism 62:1180–1188CrossRefGoogle Scholar
  13. 13.
    Elias CF, Aschkenasi C, Lee C, Kelly J, Ahima RS, Bjorbæk C, Flier JS, Saper CB, Elmquist JK (1999) Leptin differentially regulates NPY and POMC neurons projecting to the lateral hypothalamic area. Neuron 23:775–786CrossRefGoogle Scholar
  14. 14.
    Forner-Cordero I, Szolnoky G, Forner-Cordero A, Kemény L (2012) Lipedema: an overview of its clinical manifestations, diagnosis and treatment of the disproportional fatty deposition syndrome–systematic review. Clin Obes 2:86–95CrossRefGoogle Scholar
  15. 15.
    Chen S-G, Hsu S-D, Chen T-M, Wang HJ (2004) Painful fat syndrome in a male patient. Br J Plast Surg 57:282–286CrossRefGoogle Scholar
  16. 16.
    Schook CC, Mulliken JB, Fishman SJ, Alomari AI, Grant FD, Greene AK (2011) Differential diagnosis of lower extremity enlargement in pediatric patients referred with a diagnosis of lymphedema. Plast Reconstr Surg 127:1571–1581CrossRefGoogle Scholar
  17. 17.
    Langendoen S, Habbema L, Nijsten T et al (2009) Lipoedema: from clinical presentation to therapy. A review of the literature. Br J Dermatol 161:980–986CrossRefGoogle Scholar
  18. 18.
    Fonder MA, Loveless JW, Lazarus GS (2007) Lipedema, a frequently unrecognized problem. J Am Acad Dermatol 57:S1–S3CrossRefGoogle Scholar
  19. 19.
    Schmeller W, Meier-Vollrath I (2006) Tumescent liposuction: a new and successful therapy for lipedema. J Cutan Med Surg 10:7–10CrossRefGoogle Scholar
  20. 20.
    Lohrmann C, Foeldi E, Langer M (2009) MR imaging of the lymphatic system in patients with lipedema and lipo-lymphedema. Microvasc Res 77:335–339CrossRefGoogle Scholar
  21. 21.
    Stemmer R (1976) A clinical symptom for the early and differential diagnosis of lymphedema. Vasa 5(3):261–262Google Scholar
  22. 22.
    Curri S, Merlen J (1986) Microvascular disorders of adipose tissue. J Mal Vasc 11:303–309Google Scholar
  23. 23.
    Wold LE, Hines EA, Allen EV (1951) Lipedema of the legs: a syndrome characterized by fat legs and edema. Ann Intern Med 34:1243–1250CrossRefGoogle Scholar
  24. 24.
    Beninson J, Edelglass JW (1984) Lipedema—the non-lymphatic masquerader. Angiology 35:506–510CrossRefGoogle Scholar
  25. 25.
    Birkballe S, Jensen MR, Nørregaard S et al (2014) Can tissue dielectric constant measurement aid in differentiating lymphoedema from lipoedema in women with swollen legs? Br J Dermatol 170:96–102CrossRefGoogle Scholar
  26. 26.
    Naouri M, Samimi M, Atlan M, Perrodeau E, Vallin C, Zakine G, Vaillant L, Machet L (2010) High-resolution cutaneous ultrasonography to differentiate lipoedema from lymphoedema. Br J Dermatol 163:296–301CrossRefGoogle Scholar
  27. 27.
    Dimakakos P, Stefanopoulos T, Antoniades P, Antoniou A, Gouliamos A, Rizos D (1997) MRI and ultrasonographic findings in the investigation of lymphedema and lipedema. Int Surg 82:411–416Google Scholar
  28. 28.
    Duewell S, Hagspiel KD, Zuber J, von Schulthess GK, Bollinger A, Fuchs WA (1992) Swollen lower extremity: role of MR imaging. Radiology 184:227–231CrossRefGoogle Scholar
  29. 29.
    Foster K, Schwan H (1989) Dielectric properties of tissues and biological materials: a critical review. Crit Rev Biomed Eng 17:25–104Google Scholar
  30. 30.
    Alanen E, Lahtinen T, Nuutinen J (1998) Measurement of dielectric properties of subcutaneous fat with open-ended coaxial sensors. Phys Med Biol 43:475–485CrossRefGoogle Scholar
  31. 31.
    Alanen E, Lahtinen T, Nuutinen J (1999) Penetration of electromagnetic fields of an open-ended coaxial probe between 1 MHz and 1 GHz in dielectric skin measurements. Phys Med Biol 44:N169–N176CrossRefGoogle Scholar
  32. 32.
    Bakar Y, Tuğral A, Üyetürk Ü (2017) Measurement of local tissue water in patients with breast cancer-related lymphedema. Lymphat Res Biol.  https://doi.org/10.1089/lrb.2016.005
  33. 33.
    Lahtinen T, Seppala J, Viren T et al (2015) Experimental and analytical comparisons of tissue dielectric constant (TDC) and bioimpedance spectroscopy (BIS) in assessment of early arm lymphedema in breast cancer patients after axillary surgery and radiotherapy. Lymphat Res Biol 13(3):176–185CrossRefGoogle Scholar
  34. 34.
    Mayrovitz H (2007) Assessing local tissue edema in postmastectomy lymphedema. Lymphology 40:87–94Google Scholar
  35. 35.
    Bilancini S, Lucchi M, Tucci S, Eleuteri P (1995) Functional lymphatic alterations in patients suffering from lipedema. Angiology 46:333–339CrossRefGoogle Scholar
  36. 36.
    Brorson H, Ohlin K, Olsson G, Karlsson MK (2009) Breast cancer-related chronic arm lymphedema is associated with excess adipose and muscle tissue. Lymphat Res Biol 7:3–10CrossRefGoogle Scholar
  37. 37.
    Dylke E, Ward L, Meerkin J et al (2013) Tissue composition changes and secondary lymphedema. Lymphat Res Biol 11:211–218CrossRefGoogle Scholar
  38. 38.
    Dietzel R, Reisshauer A, Jahr S, Calafiore D, Armbrecht G (2015) Body composition in lipoedema of the legs using dual-energy X-ray absorptiometry: a case–control study. Br J Dermatol 173:594–596CrossRefGoogle Scholar
  39. 39.
    Peled AW, Kappos EA (2016) Lipedema: diagnostic and management challenges. Int J Women's Health 8:389–395CrossRefGoogle Scholar
  40. 40.
    Boursier V, Pecking A, Vignes S (2004) Comparative analysis of lymphoscintigraphy between lipedema and lower limb lymphedema. J Mal Vasc 29:257–261CrossRefGoogle Scholar
  41. 41.
    Szolnoky G, Borsos B, Barsony K et al (2008) Complete decongestive physiotherapy with and without pneumatic compression for treatment of lipedema: a pilot study. Lymphology 41:40–44Google Scholar
  42. 42.
    Szolnoky G, Nagy N, Kovács R et al (2008) Complex decongestive physiotherapy decreases capillary fragility in lipedema. Lymphology 41:161Google Scholar
  43. 43.
    Fetzer A (2016) Specialist approaches to managing lipoedema. Br J Commun Nurs 21:S30–S35CrossRefGoogle Scholar
  44. 44.
    Lipoedema U. The big survey: results. Presentation at the British lymphology society conference; 2013Google Scholar
  45. 45.
    Schmeller W, Hueppe M, Meier-Vollrath I (2012) Tumescent liposuction in lipoedema yields good long-term results. Br J Dermatol 166:161–168CrossRefGoogle Scholar
  46. 46.
    Wienert V, Földi E, Juenger M et al (2009) Lipoedema guidelines of the German society for phlebology. Phlebologie 38:164–167CrossRefGoogle Scholar
  47. 47.
    Peled AW, Slavin SA, Brorson H (2012) Long-term outcome after surgical treatment of lipedema. Ann Plast Surg 68:303–307CrossRefGoogle Scholar
  48. 48.
    Fetzer A, Fetzer S (2015) Early lipoedema diagnosis and the RCGP e-learning course. Br J Commun Nurs 20:S22–S28CrossRefGoogle Scholar
  49. 49.
    Bosman J (2011) Lipoedema: poor knowledge, neglect or disinterest. J Lymphoedema 6:109Google Scholar
  50. 50.
    Warren AG, Janz BA, Borud LJ et al (2007) Evaluation and management of the fat leg syndrome. Plast Reconstr Surg 119:9e–15eCrossRefGoogle Scholar
  51. 51.
    Dudek JE, Białaszek W, Ostaszewski P (2016) Quality of life in women with lipoedema: a contextual behavioral approach. Qual Life Res 25:401–408CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Bolu Abant Izzet Baysal University Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Gölköy CampusBoluTurkey
  2. 2.Department of Physical Therapy and Rehabilitation, Faculty of Health Sciencesİzmir Bakırçay UniversityIzmirTurkey

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