Sharma Reena K, Gupta Mudita, Negi Lalita
Department of Dermatology, IGMC, Shimla, Himachal Pradesh, India.
Department of Pathology, IGMC, Shimla, Himachal Pradesh, India.
Indian Dermatol Online J. 2019 Mar-Apr;10(2):149-152. doi: 10.4103/idoj.IDOJ_40_18.
Idiopathic localized involutional lipoatrophy (ILIL) is focal loss of subcutaneous tissue without any clinical or histopathological inflammation with spontaneous regression.
To retrospectively study clinical features and evolution of lesions in patients diagnosed with idiopathic localized lipoatrophy presenting to the department of dermatology of two district hospitals of Himachal Pradesh.
A retrospective study of clinical patterns and evolution of ILIL was done in patients presenting with this condition in two district hospitals in the past 4 years (October 2013-September 2017). All clinically suspected and histopathologically confirmed cases of idiopathic localized lipoatrophy were included in the study. All cases with history of antecedent injections, vaccination, or medications before the development of lesion and inflammatory lipoatrophy on histopathology were excluded.
We found a total of 12 patients with ILIL. About 66% were children (8/12), 3 (25%) young females, and 1 (8%) young adult male. The most common site involved was buttock in 9 (75%) cases followed by a single case each (8%) with lesion on arm, face, and lower back. Two children and one adult were having bilateral involvement (25%), whereas the remaining had unilateral lesions. Lipoatrophy in 8 (66%) patients decreased spontaneously (with placebo) within 4-12 weeks duration whereas 4 required treatment. None required surgical or cosmetic interventions.
Small sample size and nonavailability of immunohistochemistry reports in all patients.
ILIL is a rare form of lipoatrophy with specific loss of adipose tissue without any inflammatory changes. We concluded that ILIL is an underreported entity, probably due to its spontaneous resolution.
特发性局限性退行性脂肪萎缩（ILIL）是皮下组织的局灶性缺失，无任何临床或组织病理学炎症反应，且可自发消退。
回顾性研究喜马偕尔邦两家地区医院皮肤科诊断为特发性局限性脂肪萎缩患者的临床特征及病变演变情况。
对过去4年（2013年10月至2017年9月）在两家地区医院就诊的ILIL患者的临床模式及演变进行回顾性研究。所有临床疑似且经组织病理学确诊的特发性局限性脂肪萎缩病例均纳入研究。排除病变发生前有注射、接种疫苗或用药史以及组织病理学表现为炎症性脂肪萎缩的所有病例。
我们共发现12例ILIL患者。约66%为儿童（8/12），3例（25%）为年轻女性，1例（8%）为年轻成年男性。最常受累部位为臀部，共9例（75%），其次是手臂、面部和下背部各1例（8%）。2例儿童和1例成人有双侧受累（25%），其余为单侧病变。其中8例（66%）患者的脂肪萎缩在4至12周内自发减轻（使用安慰剂），而4例需要治疗。无人需要手术或美容干预。
样本量小且并非所有患者都有免疫组化报告。
ILIL是一种罕见的脂肪萎缩形式，具有脂肪组织的特定缺失且无任何炎症改变。我们得出结论，ILIL可能因自发消退而报告不足。
