Basic knowledge about lipedema

Lipedema. An underrated widespread disease?

Almost 10% of women in Germany have lipedema, yet around 70% of these patients do not receive adequate diagnosis and in some cases do not even know that they are ill. The reason for this is the widespread ignorance of doctors and therapists who do not properly diagnose and confuse lipedema with venous disease or obesity. The cause of lipoedema is unknown. A genetic component is assumed based on positive family history and many affected family members. A hormonal component is also suspected due to the almost exclusively female patients and an outbreak of the disease or progression in the phases of hormonal change (puberty, pregnancy, pill, menopause). It is characteristic that the diseased fat cells can not be influenced by sports or nutritional measures. A lack of transportability of the lymphatic vessels secondary to a congestion of lipid and protein-rich substances around the fat cells. Since the removal is not guaranteed, there is an increased accumulation also in the fat cells. Secondarily, chronic lymphedema and hardening of the fat cells develop in higher stages. If the lipoedema is not treated, the condition of the refractory chronic lipolymph edema occurs after about 15-20 years. The characteristic fat distribution disorder is especially evident on the extremities. It is also typical that hands and feet are slim (negative Stemmer sign), in contrast to lymphedema (positive Stemmer sign). This can be easily tested by trying to make a crease with your fingers on the second toe. If it is not possible, there is probably no lipoedema, but lymphedema or a mixed form. (Image source Ofa Bamberg).

It is also commonly referred to as the so-called "pillar leg", as the legs look columnar and due to the contours of the joints over the joints.

Further characteristic of lipoedema is the vascular fragility which results from a slight onset of hematomas with inadequate pressure or touching the extremities. Furthermore, the patients complain mostly about resting pain in the legs, especially after prolonged exposure. The aesthetic impairment due to cellulite ("mattress phenomenon") often leads to depressive illness due to the sometimes massive restriction in everyday life and by a lack of knowledge of this disease in society.

The classification is based on morphology in several stages. Stage 1 is characterized by smooth skin surface with uniformly thickened, homogeneously imposing subcutis. Stage 2 shows an uneven, predominantly wave-like skin surface, nodular structures in the thickened subcutaneous area, and in stage 3 a pronounced proliferation with overhanging tissue parts (swelling) on the arms and legs.

Furthermore, one differentiates (according to Herpertz) into 6 different types: thigh type, lower leg type, whole bone type, upper arm type, forearm type or allarm type. The lipoedema can spread to the entire body and manifest on each extremity. The most important differential diagnosis is obesity, which is why BMI plays an important role in diagnostics. Of course, mixed forms of lipoedema, lymphedema and obesity also occur in the higher course.

Probably the most important distinguishing criterion for obesity is the painfulness of this disease. It is not just an aesthetic problem that afflicts sufferers, but increasingly causes pain and tension, especially with summery temperatures.

Do you want to know more? At the Klinikum Rechts der Isar takes place on 26.05. on these topics lipoedema / lymphoedema a free information day instead of in which on the possibilities of reimbursement by health insurance, legal opposition and therapeutic measures and current research is pointed out.

If you are interested, you are very welcome to contact me personally. I am the organizer of the symposium and will give a lecture myself. You are cordially invited to come over and inform yourself.

Continuing knowledge about lipedema