Thursday, February 25, 2010

Lipedema, Lymphedema, Lipolymphedema

There is an interesting article (full reference below)on lipedema.  If you have an interest in the subject, then read the full article.  The terms are so similar that I found myself having to be careful (often deliberately speaking the terms out loud) when I read the article.  Even though the topic is “no laughing matter”  you could easily make a tongue-tying word game out of the words:  lipedema, lymphedema, lipolymphedema.

Lipedema is a condition in which there is a pathological deposition of fatty tissue, usually below the waist, leading to progressive leg enlargement.  The diagnosis of lipedema is a clinical one, often challenging in patients who are overweight or obese, based on the examination and history. 

Distinguishing obesity from lipedema can be accomplished by noting (a) whether the fat deposits in the arms and legs spare the feet and hands, (b) whether the adiposity is predominantly in the extremities or it exists in the extremities and the trunk, and (c) by whether diet and/or physical activities reduce truncal adiposity but not extremity adiposity.   Easy bruising is often noted. Pain upon pressure is universal in patients with lipedema and is commonly described an "aching dysesthesia.

Lymphedema is a condition in which edema leads to inflammation and fibrosis as a result of reduced lymphatic return.

Lipolymphedema is the condition in which lipedema acquires a lymphedema component and is thus differentiated from pure lipedema by the presence of Stemmer's sign.

The Stemmer's sign is the inability to pinch a fold of dorsal skin at the base of the toes and will be positive in patients who have developed secondary lymphedema.   In patients with pure lipedema, the Stemmer's sign is negative. In lipedema patients, edema is minimal and relieved by elevation. In lymphedema patients, the edema is persistent.

Photo credit

 

 

 

REFERENCE

Lipedema: A Frequently Misdiagnosed and Misunderstood Fatty Deposition Syndrome; Advances in Skin & Wound Care, February 2010 - Volume 23 - Issue 2 - pp 81-92; Fife, Caroline E. MD; Maus, Erik A. MD; Carter, Marissa J. PhD, MA

A Guide to Lymphedema; Medscape article, 01/23/2008; Kristiana D Gordon; Peter S Mortimer

Lipedema and Lymphedema; LymphNotes.com

Lipedema; Lymphedema Therapy Website

3 comments:

StorytellERdoc said...

Nice post, Ramona. Like your medical acuity and opening my eyes to what I don't usually see in the ER (thankfully, I am glad you see more lymphedema cases than I do!)
Jim

Gizabeth Shyder said...

I didn't know I could get tongue tied without even opening my mouth.

agent99 said...

Wow, I often see both entities, but rarely differentiated them. Thanks for a great post. Now if I can only figure out how that could inspire a quilt.....
Thanks!