Department of Dermatology, Istanbul Medeniyet University, School of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey.
Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University, Dresden, Germany.
Dermatol Ther. 2021 Jan;34(1):e14364. doi: 10.1111/dth.14364. Epub 2020 Oct 12.
Lipedema is a painful, underdiagnosed adipose tissue disorder, characterized by symmetrical swelling of the extremities due to subcutaneous fat deposition in the buttocks, thighs, legs, and arms, sparing the most distal part of the extremities. Although etiology and pathogenesis of lipedema is unclear, possible role of hormonal and genetic factors have been proposed previously. Patients with lipedema suffer from pain, easy bruising, tenderness, and disfigurement. Pain is the leading symptom in lipedema. Since the pain is associated with depression and impaired quality of life, reduction of pain is the major therapeutic approach. Pain in lipedema is attributed to allodynia, exaggerated sympathetic signaling, and estrogens. Although the mechanism of pain in lipedema is uncertain, effective treatment of lipedema should provide a satisfactory pain reduction. Efficacy of the conservative treatment is a matter of debate. Microcannular tumescent liposuction is the most effective therapeutic option for lipedema. There is a large body of evidence that this procedure significantly reduces pain in patients with lipedema.
脂肪水肿是一种疼痛性、诊断不足的脂肪组织疾病，其特征为臀部、大腿、小腿和手臂的皮下脂肪沉积导致四肢对称性肿胀，而四肢最远端未受累。尽管脂肪水肿的病因和发病机制尚不清楚，但先前已经提出了激素和遗传因素的可能作用。脂肪水肿患者会出现疼痛、容易瘀伤、压痛和畸形。疼痛是脂肪水肿的主要症状。由于疼痛与抑郁和生活质量受损有关，因此减轻疼痛是主要的治疗方法。脂肪水肿的疼痛归因于感觉过敏、交感神经信号过度放大和雌激素。尽管脂肪水肿疼痛的机制尚不清楚，但有效的脂肪水肿治疗应该能提供令人满意的疼痛缓解。保守治疗的疗效存在争议。微创肿胀吸脂术是治疗脂肪水肿最有效的治疗选择。有大量证据表明，该手术可显著减轻脂肪水肿患者的疼痛。
