Lipoedema is not lymphoedema: A review of current literature

Abstract

Lipoedema is a rare painful disorder of the adipose tissue. It essentially affects females and is often misdiagnosed as lymphoedema or obesity. It is globally misdiagnosed or underdiagnosed, and the literature is lacking appropriate guidance to assist clinicians towards this diagnosis. However, the need to recognise this disorder as a unique entity has important implications to establish proper treatment and, therefore, its tremendous effect on patients. Early diagnosis and treatment can turn these patients' lives upside down. The aim of this review is to focus on the clinical guidance, differential diagnosis, and management strategies. In addition, other aspects of lipoedema, including epidemiology and pathogenesis, are also being discussed here. Lipoedema is distinct from obesity and distinct from lymphoedema, although it might progress to involve the venous and lymphatic system (venolipedema or lympholipedema or both). Late diagnosis can leave the patient debilitated. Management of lipoedema includes weight loss, control of oedema, complex decongestive physiotherapy, liposuction, and laser-assisted lipolysis. However; there are increasing reports on tumescent liposuction as the preferred surgical option with long-lasting results. The role of more randomised controlled studies to further explore the management of this clinical entity remains promising.

Increase in Leptin and PPAR-γ Gene Expression in Lipedema Adipocytes Differentiated in vitro from Adipose-Derived Stem Cells

“…This disorder is characterized by a symmetrical increase of fat deposition in the legs and the arms, sparing the hands and the feet [3][4][5]. The symptoms of lipedema are often confused with obesity, lymphedema, chronic venous insufficiency and other fat disorders [6][7][8][9][10]. Lipedema consists of three stages characterized by the texture of skin and tissue formation: Stage 1 has normal smooth skin over pearl-sized nodules in a hypertrophic fat layer; Stage 2 has skin indentations over a hypertrophic fat structure of pearl to-apple-size masses; and Stage 3 has large extrusions of tissue causing skin and fat deformations mainly on the thighs and around the knees.…”

Treatment of lipedema by low‐volume micro‐cannular liposuction in tumescent anesthesia: Results in 111 patients

“…Stemmer's sign is negative in lipedema. Hand and feet are spared leading to the cuff sign on the most distal parts of lower legs or lower arms, separating it from lymphedema (Shavit, Wollina, & Alavi, 2018;Wollina & Heinig, 2018). A capillary fragility develops that causes bruising after minor trauma.…”

Lipedema—An update

“…It leads to a disproportionate body shape. In contrast to lymphedema, lipedema leaves the most distal parts, that is, hands and feet, unaffected (step-off sign or cuff sign) (Allen & Hines, 1940;Shavit, Wollina, & Alavi, 2018). The Stemmer sign is negative in lipedema (Wollina & Heinig, 2018).…”