Alosaimi Khalid, Mortada Hatan, Alshomer Feras
From the College of Medicine, King Saud University, Riyadh.
Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Plast Reconstr Surg Glob Open. 2024 Sep 18;12(9):e6173. doi: 10.1097/GOX.0000000000006173. eCollection 2024 Sep.
Lower limb swelling presents a diagnostic challenge with diverse causes, including well-known issues like venous insufficiency and lymphedema, and less-understood conditions like lipedema. Lipedema, involving abnormal fat accumulation in the lower extremities, is frequently misdiagnosed, posing challenges for affected individuals. This research aimed to report and analyze the clinical features of patients presenting with the complaint of lipedema.
A retrospective cross-sectional study was conducted in Saudi Arabia from April to November 2023, involving adult patients from a specialized clinic in lipedema and lymphedema management. Data were collected through clinical evaluation and a comprehensive data collection sheet.
In a cohort of 115 female patients (mean age: 38.58), the most common age for disease onset was around 20-29 years. Physical examinations revealed symmetric enlargement (88%), collar sign (43%), orthostatic nonpitting edema (49%), and telangiectasia (64%). Varicose veins were present in 36%, Stemmer signs in 2%, and foot edema in 13%. Clinical diagnosis with lipedema occurred in 71%, with grade 2 (31%) as the most common severity and type 3 (47%) as the prevalent disease type.
The current study, the first of its kind in the Middle East and specifically in Saudi Arabia, emphasizes the urgency of increased awareness and intervention due to a high underdiagnosis rate in lipedema. The observed complexity in symptoms and correlations between severity, lymphatic impairment, and body mass index underscore lipedema's multifaceted nature. Future research should explore regional and cultural influences and conduct larger studies to validate and recognize various lipedema features.
下肢肿胀的诊断具有挑战性，其病因多种多样，包括诸如静脉功能不全和淋巴水肿等常见问题，以及像脂肪性水肿这类了解较少的病症。脂肪性水肿涉及下肢异常脂肪堆积，常被误诊，给患者带来诸多挑战。本研究旨在报告并分析以脂肪性水肿为诉求的患者的临床特征。
2023年4月至11月在沙特阿拉伯进行了一项回顾性横断面研究，纳入了来自脂肪性水肿和淋巴水肿管理专科诊所的成年患者。通过临床评估和一份全面的数据收集表收集数据。
在115名女性患者队列中（平均年龄：38.58岁），疾病发病的最常见年龄在20 - 29岁左右。体格检查发现对称肿大（88%）、领口征（43%）、体位性非凹陷性水肿（49%）和毛细血管扩张（64%）。36%的患者有静脉曲张，2%有施特默征，13%有足部水肿。71%的患者临床诊断为脂肪性水肿，其中2级（31%）是最常见的严重程度，3型（47%）是最普遍的疾病类型。
本研究是中东地区尤其是沙特阿拉伯的首例此类研究，强调了由于脂肪性水肿的漏诊率高，提高认识和进行干预的紧迫性。观察到的症状复杂性以及严重程度、淋巴损伤和体重指数之间的相关性凸显了脂肪性水肿的多面性。未来的研究应探索区域和文化影响，并开展更大规模的研究以验证和识别各种脂肪性水肿特征。
