Cellulite: nature and aetiopathogenesis

Abstract

Only a limited number of studies on cellulite have been published in the international literature and many of them reach somewhat antithetical conclusions. Consequently, it is not yet possible to reconcile the extreme differences of opinion which have lingered on for years concerning the nature of this disorder, as well as its origin and even the most basic aspects of its histopathological classification. It does not even have a recognized name: in fact, the term 'cellulitis' is used in scientific English to indicate a spreading gangrenous infection of the subcutaneous cellular tissue. The other terms used from time to time [panniculitis, lipodystrophy, edematofibrosclerotic panniculitis (EFP), liposclerosis, lipoedema, etc.] have quite different morphological and pathogenetic connotations in general. Over the last few decades, three major conflicting theories have emerged in relation to the ethiopathogenesis of cellulite. These indicate, respectively, the following causes: 1. Oedema caused by excessive hydrophilia of the intercellular matrix. 2. A homeostatic alteration on a regional microcirculatory level; this pathogenetic theory is summarized in a synthetic and self-explanatory denomination: EFP. 3. A peculiar anatomical conformation of the subcutaneous tissue of women, different from male morphology.These theories must all now be updated in the light of recent advances on the sophisticated and composite physiopathology of the adipose organwhich acts not only as a control device which regulates the systematic equilibrium of energy and modulates the food intake and the metabolism of other tissue substrate through a multiple glandular secretion of hormones and parahormones. Ré suméSeulement un nombre limité d'études sur la cellulite a été publié dans la littérature internationale et beaucoup de ces articles arrivent à des conclusions plutôt antithétiques. Par conséquent, actuellement il est impossible de reconcilier les opinions extrèmement différentes concernant la nature de ce désordre, ainsi que son origine, de même que les aspects les plus basilaires de sa classification histopathologique. Le nom même de cette affection n'est pas reconnu: en fait le terme '' cellulite ''est utilisé dans le language scientifique pour indiquer une inflammation du tissu cellulaire sous-cutané, d'origine infectieuse. Les autres termes employés de temps an temps tels que panniculopathie, lipodystrophie, panniculopathie oedémato-fibroscléreuse, liposclérose, lipoedème etc. ont en general des connotations morphologiques e pathogénétiques tout à fait différentes. Au cours des dernières décen-nies, trois principales théories contradictoires ont émergé pour ce qui concerne l'etiopathologie dela cellulite. Chacune théorie indique respectivement les suivantes causes:

Análise Da Intervenção Fisioterapêutica Com O Uso De Ultrassom E Drenagem Linfática Manual No Fibro Edema Gelóide

“…Devido a baixa penetração do ultrassom, não foi suficiente para atingir a camada adiposa das pacientes estudadas, entretanto não houve acompanhamento adequado de alimentação, onde as pacientes apresentaram um ga- 20 . Embora tenha-se demonstrado a importância da atuação do fisioterapeuta no tratamento do fibro edema gelóide, através desta revisão, demonstramos ainda haver uma carência de evidências científicas, com estudos controlados, que consigam determinar os métodos fisioterapêuticos de intervenção mais evidentes para serem utilizados nos programas de tratamento.…”

Treatment of Edematofibrosclerotic Panniculitis (Cellulite) and of Localised Adiposity with Extracts of Birch, Melilotus, Orthosiphon, Bromelin and Red Vine Leukocyanidine: Results from a Single-Centre Observational Prospective Study

“…A large number of studies focused on the research of the causes of such disorder [1], on the possible risk factors which influence EFP and its most effective treatment methods [2]. Currently, in addition to the various possible surgical treatments (liposuction-liposculpture, laser-lipolysis, etc.)…”

The Effect of Combination of Red, Infrared and Blue Wavelengths of Low-Level Laser on Reduction of Abdominal Girth: A Before-After Case Series

“…[30][31][32][33] One of the cellulite predisposing factors is circulatory insufficiency. 1,[5][6][7] Over this fact, ameliorating tissue perfusion by blue light may be effective in decreasing problems of circulation and reducing localized adiposity. The experimental objective of this study, therefore, was to evaluate the application of a 630 nm red laser, 808 nm infra-red laser and a 450 nm blue LED (blue laser was not available) for non-invasive reduction of circumference in patients with abdominal localized adiposity.…”