Department of Dermatology, Haydarpasa Numune Training and Research Hospital, Eski toptasi cad. Beyaz saray apt. A blok 125/6 Uskudar, Istanbul, Turkey.
Eur J Dermatol. 2011 Jul-Aug;21(4):520-8. doi: 10.1684/ejd.2011.1385.
Little is known about lipedematous scalp (LS) and lipedematous alopecia (LA). We investigated the clinical and histopathological features of LS and LA with a 7-year retrospective re-evaluation of 31 patients. 23 cases were LS and 8 LA, with 25 females and 6 males. The overweight and obese groups contained 15 patients with 16 within the normal weight range. Scalp thickness varied between 9-18 mm in our patients by magnetic resonance imaging. Thickening of the subcutaneous adipose tissue layer was present in all cases. Dermal edema was seen in 22 patients, lymphatic dilatation in 17 and elastic fiber fragmentation in 21. When the relationship between dermal edema and elastic fibers was investigated, elastic fiber fragmentation was found in 86.4% of cases with dermal edema. Collagen fragmentation and coarsening were seen in two cases, and collagen was normal in 24 cases. The number of follicles was decreased in 9 cases and normal in 17. The clinical and histopathological findings were not statistically different between LS and LA groups (p>0.05). The majority of the patients in our study were females, suggesting an underlying hormonal pathology. The association with obesity suggested that anatomical differences can be present in lipid distribution. Dermal edema and lymphatic dilatation suggested the primary pathology is lymphatic system.
关于脂肪性头皮（LS）和脂肪性脱发（LA）知之甚少。我们通过对 31 名患者的 7 年回顾性重新评估，研究了 LS 和 LA 的临床和组织病理学特征。23 例为 LS，8 例为 LA，其中女性 25 例，男性 6 例。超重和肥胖组中有 15 名患者，正常体重组中有 16 名患者。我们的患者磁共振成像（MRI）显示头皮厚度为 9-18mm。所有病例均存在皮下脂肪组织层增厚。22 例患者存在真皮水肿，17 例患者存在淋巴管扩张，21 例患者存在弹性纤维断裂。当研究真皮水肿与弹性纤维的关系时，发现 86.4%的真皮水肿病例存在弹性纤维断裂。2 例患者存在胶原纤维碎裂和变粗，24 例患者胶原纤维正常。9 例患者毛囊数量减少，17 例患者毛囊数量正常。LS 和 LA 组的临床和组织病理学表现无统计学差异（p>0.05）。我们研究中的大多数患者为女性，提示存在潜在的激素病理学。与肥胖的相关性表明，脂质分布可能存在解剖差异。真皮水肿和淋巴管扩张提示主要病理学为淋巴系统。
