Lipedema

Lipedema
Synonyms	Lipoedema, Lipödem, Lipalgia, Adiposalgia/Adipoalgesia, Adiposis dolorosa, Lipomatosis dolorosa of the legs, Lipohypertrophy dolorosa, Painful column leg, Painful lipedema syndrome
Pronounced lipedema of the right leg (the knee pointing to the right and is concealed by the overhanging lipedema). This is a very advanced case, possibly Stage 4 with lymphedema as well - lipolymphedema.
Classification and external resources
Specialty	Vascular Medicine
ICD-10	R60, E88.2
OMIM	614103
DiseasesDB	7491
MeSH	D065134
Orphanet	77243
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Lipedema or lipoedema (European spelling) is an incurable, chronically progressive affliction that occurs almost exclusively in women. It causes a symmetrical accumulation of fat in the subcutaneous tissue that disproportionately affects the lower limbs from buttocks to ankles. The legs may also be sensitive and prone to easy bruising. In some cases, the upper arms can also accumulate distinct patterns of fatty tissue.

Lipedema is little known, under recognized, and generally misdiagnosed as simple obesity. Despite the fact that it's been named for over 75 years, it is only recently that interest and education about lipedema is gaining in awareness. Estimates of the incidence of lipedema vary widely, and range as high as 11% of the post-pubertal female population, with estimates of 17 million women in the US, and 370 million women worldwide affected.

Patients tend to gain weight in lipedematous areas and lose it in non-lipedematous areas, though there are cases where weight loss has resulted in improvement of the condition. Obese lipedema patients who undergo bariatric surgery lose fat primarily from the waist up. While lipedema presents itself in various ways, diagnosis is possible as early as pre-puberty when inner thigh pads present and at any age when fat gathers and drapes at knees.

Symptoms of lipedema include disproportionately large, column-like legs, legs unusually large to the knees, disproportionate hips, stomach or buttocks. As lipedema progresses, patients become increasingly heavy in the lower body. The additional, expanding fat cells interfere with the pathways of lymphatic vessels, and patients can develop secondary lymphedema, a condition known as lipo-lymphedema. Many lipedema patients cannot tolerate the compression garments associated with conventional lymphedema treatment because the underlying lipedematous fat is very painful, and those patients therefore are at risk for the side effects of uncontrolled lymphedema, including recurring blood infections and fibrosis. If not kept in check through a healthy lifestyle, lipo-lymphedema can worsen, and patients will become progressively less mobile.

The cause is unknown. There are likely genetically inherited risk factors as it is more likely to occur in the first and second degree relatives of affected individuals. It appears to be related to estrogen and progesterone hormonal influences as it occurs exclusively post puberty and largely in females. There is a strong inflammation component.

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Wikipedia