Background: Symmetric lipomatoses are characterized by marked symmetric deposition of diffusely distributed fatty tissue. Though relatively common disorders, they are rather rarely reported in the literature, possibly being misdiagnosed as general obesity. While the differential diagnosis of symmetric lipomatosis versus general obesity may not appear difficult in males, it is obviously problematic in females. Observations: We describe the findings in 6 representative female patients with symmetric lipomatoses: 3 with benign (multiple) symmetric lipomatosis and 3 with female zonal obesity. The former disorder was characterized by massive, firm, symmetric fat deposition predominantly around the neck and shoulder girdle and was clearly associated with alcohol abuse and/or liver disease. There were no malignant tumors of the upper airways. In the latter case, fatty tissue had accumulated mainly at the buttocks and thighs but characteristically spared the feet and hands. Tenderness was a common symptom. This disorder showed familial predisposition. Histology in both cases revealed normal fatty tissue which was neither encapsulated nor septally divided. Conclusions: We suggest that the term ‘symmetric lipomatoses’ refers to two separate disorders, benign (multiple) symmetric lipomatosis and female zonal obesity.

765 References1 Kragballe K, Beck HI, Sogaard H. Improvement of psoriasis by a topical vitamin D3 analogue (MC903) in a double-blind study. Br J Dermatol 1988; 119: 223 -230. 2 Dubertret L, Wallach D, Souteyrand P et al. Efficacy and safety of calcipotriol (MC903) ointment in psoriasis vulgaris. A randomised, double-blind, right/ left comparative, vehicle-controlled study. J Am Acad Dermatol 1992; 27: 983-988. 3 Ashcroft M, Li Wan Po A, Williams HC, Griffiths CEM. Systematic review of comparative efficacy and tolerability of calcipotriol in treating chronic plaque psoriasis. Br Med J 2000; 320: 963 -967. 4 Bourke JF et al. Occlusion enhances the efficacy of topical calcipotriol in the treatment of psoriasis vulgaris. Clin Exp Dermatol 1993; 18: 504 -506. 5 Holick MF, Pochi P, Bhawan J. Topically applied and orally administered 1,25-dihydroxyvitamin D 3 is a novel safe and effective therapy for the treatment of psoriasis: a three year experience with histologic analysis. J Invest Dermatol 1989; 92: 446. 6 Kato T, Rokugo M, Terui T, Tagami H. Successful treatment of psoriasis with topical application of the active vitamin D 3 analogue 1α,24-dihydroxycholecalciferol. Br J Dermatol 1986; 115: 431-433. 7 Raymond GP. Hydrocolloid dermatological patch over a corticosteroid cream in treatment of psoriasis. Curr Ther Res 1989; 5: 767-774. 8 Fry L, Almeyda J, McMinn R. Effect of plastic occlusive dressing on psoriatic epidermis. Br J Dermatol 1970; 82: 458 -462. 9 Fisher LB, Maibach HI. Physical occlusion controlling epidermal mitosis. J Invest Dermatol 1972; 59: 106-108. 10 Marriot C, Martin GP. Preclinical results of a new hydrocolloid patch used in conjunction with topical corticosteroids in inducing the blanching response. In: Ryan TH, ed. Beyond Occlusion Dermatology Proceeding. Royal

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