Lipedema

Lipedema ( colloquially jodhpurs syndrome, columns leg or breeches obesity) is an atypical and symmetrical accumulation of fatty tissue on the side of the hips and thighs and upper arms (which later also on the lower legs, forearms and back of neck ), associated with pain and tenderness of the legs and easy bruising ( " bruises " ) with trivial traumas. Secondarily it can also lead to peripheral edema. It is a progressive disease.

Lipedema occurs almost exclusively in women, especially after puberty, after pregnancy or during menopause. A genetic predisposition is suspected, however, hormonal changes and weight gain are traded as potential causes. The fat cells are affected pathologically altered.

Lipedema is not the expression of obesity - which is why it is not promising to recommend that the affected patients on a diet.

The pathologically altered adipose tissue tends ( by disruption of capillary function ) in addition also to water retention, which can lead to feelings of tension and pressure pain throughout. It is primarily no damage to the lymphatic system, the remainder of this, however, can be damaged by the increased vulnerability and to inflammation of adipose tissue and thus the disposition for edema are increased.

Severities

  • Type I: fatty tissue in the area of buttocks and hips ( jodhpurs phenomenon )
  • Type II: Lipedema is up to the knees, fatty lobe formation in the knee inside
  • Type III: Lipedema ranges from the hips to the ankles
  • Type IV: arms and legs are affected up to the wrists / ankles, so with the exception of the feet and hands
  • Type V: Lipolymphödem with increased water retention in hands and feet and fingers and toes

Stages of skin lesions

  • Stage 1: feinknotige skin surface, commonly known as orange peel,
  • Stage 2: grobknotige skin surface with larger dents, " mattress phenomenon "
  • Stage 3: large, deforming skin flap and bead near

Other symptoms

  • Symmetrical, spongy swelling
  • Touch and pressure
  • Tendency to hematoma formation after minor trauma
  • Skin is at an advanced stage with blood often cool and bad
  • Depending on the stage orange peel, mattresses skin or large fat lobes
  • Because of the fat lobes disturbances in gait, knock-knees

Differential diagnosis

The visual and palpation (inspection and palpation) and individual patient history serve the doctor as reliable evidence for the diagnosis. In contrast to the lymphedema Stemmersche sign is always negative, that is, at a Lipoedema can be a fold of skin on the toes or fingers stand out.

In order to diagnose a Lipoedema sure, must be ruled out that the symptoms listed may be caused by these diseases:

  • Lipohypertrophy
  • Primary lymphedema

Therapy

  • Compression therapy by wearing compression tights to class IV compression combined with sports
  • Weight normalization
  • Intermittent pneumatic compression
  • Respiratory Physiotherapy
  • Functional rehabilitation
  • Cold chamber
  • Surgical treatment by liposuction (liposuction ), however, this can cause by the destruction of the superficial lymphatics to an additional lymphedema.
  • At Lipolymphödem possibly manual lymphatic drainage
Climacteric (human) Cellulite
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