Wollina U, Heinig B
Klinik für Dermatologie und Allergologie, Städtisches Klinikum Dresden, Friedrichstr. 41, 01067, Dresden, Deutschland.
Zentrum für Physikalische Therapie und Rehabilitationsmedizin, Städtisches Klinikum Dresden, Dresden, Deutschland.
Z Rheumatol. 2018 Nov;77(9):799-807. doi: 10.1007/s00393-018-0546-y.
Lipedema is a symmetrical disorder of the subcutaneous adipose tissue that affects almost exclusively women in postpubescent age. The trinity of disfiguring hyperplastic adipose tissue of the proximal extremities, increasing pain over time and bruising is characteristic. Lymphedema can occur in both sexes and is differentiated into primary and secondary subtypes. Symmetry is not a prerequisite for diagnosis. Characteristic for lymphedema is the disproportion between lymphatic fluid and the capacity of lymphatic vessels. The most distal body parts are always more severely affected than proximal parts. In the initial phases lymphedema is painless but in advanced stages tension pain can occur. The combination of both disorders has been described; however, lipedema is not responsible for subsequent lymphedema in contrast to central obesity, which significantly increases the risk of lymphedema. The differential diagnosis is of utmost importance for a meaningful management.
脂肪性水肿是一种皮下脂肪组织的对称性疾病，几乎仅影响青春期后的女性。其特征为近端肢体的增生性脂肪组织畸形、疼痛随时间加剧以及出现瘀伤。淋巴水肿可发生于男女两性，分为原发性和继发性亚型。对称性并非诊断的必要条件。淋巴水肿的特征是淋巴液与淋巴管容量之间的失衡。身体最远端部位总是比近端部位受影响更严重。在初始阶段，淋巴水肿无痛，但在晚期可能会出现张力性疼痛。两种疾病的合并情况已有描述；然而，与中心性肥胖不同，脂肪性水肿并非后续淋巴水肿的病因，中心性肥胖会显著增加淋巴水肿的风险。鉴别诊断对于有效的治疗至关重要。
