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12th State of Georgia Lymphedema Awareness Program

Sun, 18 Oct 2009 10:19:09 GMT

12th State of Georgia Lymphedema Awareness Program

Lighthouse Lymphedema Network

THERE IS STILL TIME TO GET THOSE REGISTRATIONS IN

An educational and awareness conference for patients, caregivers and professionals!

Where?

Saint Joseph Hospital Auditorium 5665 Peachtree Dunwoody Road, NE Atlanta, GA 30342

When?

Saturday, October 24, 2009 7:30 am - 5:00 pm

Click here for Registration Form

Schedule

7:30-8:15am Registration – Continental Breakfast – Exhibits 8:15-8:30am Welcome
..

Plenary Session:

8:30-10:00am Moderator: Elaine Gunter, MT (ASCP)

Nicole Stout, PT, MPT, CLT-LANA Will discuss her studies on early intervention for breast cancer including the anatomy, reconstruction, breast cancer surgeries, truncal and other upper extremity lymphedema

10:00-10:30am Break Exhibits

10:30-12:00 Charles McGarvey, PT, DPT, MS, FAPTA

Lymphedema Secondary to Pelvic Cancer Treatment: A Review of Literature and Clinical Practice

12:00 – 1:30pm Lunch Exhibits

1:00-2:15pm Teen (only) Networking -Parent Networking (parents of children with lymphedema)

Separate sessions

Plenary Session:

1:30-2:15pm Daniel Beless, MD, Director of Wound Care at Saint Joseph Hospital Wound Care and the lymphedema patient

2:15-3:00pm DeCourcy Squire, PT, CLT-LANA

Research updates from the International Society of Lymphology of Lymphedema Diagnosis and Treatment

3:00-3:30pm Break Exhibits

3:30-4:30pm Panel Discussion

All speakers will participate in this question and answer discussion

4:30-5:00pm Closing Remarks

arks

Lipedema and Dercums Disease

Mon, 21 Sep 2009 04:56:59 GMT

Lipedema and Dercums Disease

Many in research for lipedema feel that Lipedema is actually the same condition as Dercum's Disease and Adipose Dolorsa Type I. I need to point out as well that man may diagree due to supposed differences. The supposed difference is due to the fact that in lipedema, the trunk, hands and feet are not involved. Those of us who are familiar understand just how untrue that claim is however. Another is the subject of lipomas. There is a supposed diference in size and tissue composition between lipedema and the ones in Dercums.

I will let the reader through their own research draw the conclusions one way or the other.

Pat

Septermber 21, 2009

Dercums Disease/Adiposis Dolorosa

First identified by Francis X. Dercum, in 1892, Dercums Disease (also Dercum Disease or Adiposis Dolorosa) is described several ways in the literature. Here are two:

"A disease accompanied by painful localized fatty swellings and by various nerve lesions. It is usually seen in women and may cause death from pulmonary complications." (Dorland, 27th ed) [This definition is found in National Library of Medicine: IGM Metathesaurus Information.]

Paraphrasing the National Organization of Rare Diseases (NORD):

"Dercums Disease is a rare disorder in which there are fatty deposits which apply pressure to the nerves, resulting in weakness and pain. Various areas of the the body may swell for no apparent reason. The swelling may disappear without treatment, leaving hardened tissue or pendulous skin folds."

Morbus Dercum (Adiposis dolorosa) is a chronic disease with mild to intensive pain in the fatty tissue, fatigue and obesity as the most apparent symptoms. But the disease affects the entire body and can present a long list of symptoms. This disorder usually occurs in females between the ages of 25 and 60, but can début in all ages, as well as in younger people and amongst males. It is about 20 times more frequent in females than in males. Dercums Disease, was originally described in the medical literature in 1892 by the American doctor Frances Xavier Dercum.

Symptoms

Pain in the fatty tumors lasting for at least three months. Often obesity occurs in a short period of time. But there is also a type of Dercums Disease that can occur without overweight. The pain in fat and skin can be very intensive and can be described as aching, stabbing, smarting or burning. Swellings consisting of irregularly shaped soft fatty tissue deposits may occur in many areas of the body. These deposits may spontaneously disappear, leaving hardened lumpy or rope-like tissue or pendulous folds of skin. The pain is chronic and increases with the years, but varies much in cycles. It can exist in practically the entire fatty tissue layer, but most commonly affected are the knees, trunk, forearms and thighs, sometimes sparing of the face and hands. Severe asthenia (weakness)has been emphasized as a feature by some. The pain is spontaneous and increases powerfully even at gentle touch, and massage can feel unpleasant. Some affected individuals may experience depression, lethargy, and/or confusion.Lipomas, "fatty tumors " can be felt in the fat, they are intensely painful, and usually harmless, unless a tumor moves to the lung or heart which can be fatal.

Other common symptoms are:

Various areas of the body may swell for no apparent reason. The fingers becomes clumsy, you drop things and sometimes the fingers go numb.

·Disturbed sleep, many have difficulties going to sleep because of the pain, but other forms of sleeping disorders also occur.

·General fatigue, gets worse with even mild activity.

·Tendency to become black and blue that seems to arise spontaneously or after alleviated blow.

·Stiffness after resting especially in the mornings.

·Skeletal pain in wrist, elbows, hips, tail bone and the long bones in arms and legs.

·Headache, usually an combination between tension headache and classic migraine.

·Memory lapses and concentration difficulties makes it difficult to learn new things and to accomplish demanding intellectually jobs.

·Feeling hot is often felt by the patients, some have 37,5-39 Celsius degree fever several weeks in a row , with increased pain and incapacity to work as consequence. The reason are unknown.

·Tenderness under the feet, it feels like walking on glass.

·Tenderness in the skin, difficulties to wear tight fitting clothes or take a shower.

·Infection sensitivity. Frequently increased pain during infections or active allergy attacks.

The pain seems to depend on the temperature and the weather and decreases normally at dry heat. Warm baths have a positive but temporary impact, though some patients do not tolerate heat. Generally increases pain in conjunction with menstruation. Sexual relation problems can arise because of the pain. Dercum's pain always exists, regardless if you sleep or are awake. The diagnosis of Dercums Disease implies a long, chronic pain syndrome of debilitating nature. The pain can make it difficult to: walk, drive a car, open the water tap, lift items from shelves, carry bags, open heavy doors, vacuum-cleaning, hang laundry, wash floors, wipe windows etc.

Causes

The causes of the disease are poorly researched. The symptoms and the lack of treatments can seriously affect the quality of life. Since the disorder does not show on the outside it can be hard for others to see the level of difficulties and discomfort the patient experiences. More than half of the patients are unable to work. The disorder can grow slowly for many years or very quickly because of external stress, such as: surgery, pregnancy or flu. Dercums Disease is thought to be inherited as an autosomal dominant genetic trait ,particularly strong in the line grandmother-mother-daughter. According to the latest research, Dercums Disease is an auto-immune disease such as rheumatism, and not a metabolic disturbance, that was believed earlier.

Diagnosis and treatment

The Dercums Disease diagnosis is based on what the patient tells and what the doctor finds at his examination. There are no tests to take, but some blood samples can show signs of infection and/or that the immune system are very active. The doctor can also take blood samples in order to exclude other diseases. The knowledge about the disorder is not well know and many patients are poorly The pain can last for hours, can be paroxysmal (occurring only at certain times) or continuous, and worsens with movement. Dercum disease is often associated with generalized weakness, depression, and irritability. The condition can also be associated with early congestive heart failure, myxedema (a condition associated with severe hypothyroidism), joint pain, paroxysmal flushing episodes, tremors, cyanosis (bluish discoloration of the skin), hypertension (high blood pressure), headaches, and epistaxis (nosebleeds).

Treatment:

·Medication that decreases the pain and improves the sleep

·Massage

·Warmth and warm baths

·Acupuncture

·Practicing relaxation techniques

·Avoiding physical and psychological stress

Information about the disorder and how to live with it:

Treatment of Dercums Disease is primarily directed at easing painful episodes. Surgical excision of fatty tissue deposits around joints may temporarily relieve symptoms although recurrences often develop. Intravenous infusions of the local anaesthetic drug lidocaine may give temporary relief from pain. Additional treatments of lidocaine may be necessary periodically to sustain the effect. Another analgesic drug, peroral mexiletine, may also be effective in eliminating pain for variable periods of time. Psychotherapy may be helpful for enabling affected individuals to cope with long-term intense pain. Other treatment is symptomatic and supportive.

Dercums Disease causes obesity with painful fatty tumor and fatigue. It is a chronic, often very painful disease that has incapacitating consequences. It's obvious that this disease affects all aspects of a patient's life, but the more the patient and relatives learn about the disorder and how to manage to live with it, the better results they can achieve. Collaboration is needed and occasionally a big effort by the patient to learn to live with the disorder. Patients find that they can no longer do all that was easy before. People with Dercums Disease feel pain for a number of reasons. Small things that other takes for granted, such as wringing a washcloth, opening a can or taking a shower, can be an extremely painful experience. It is important that Dercums Disease patients receive reliable information about the disorder and support from the surrounding community in order to be able to live as positively as possible and that they find their own capabilities. This helps the patient to be less dependent on others, which is of major importance in both family and working life.

Resources:

http://dercums_data.tripod.com

Dercum's Disease - Talk about this disease online with others who have it. Join the chat every Tuesday at 7 p.m. PDST (or 10 p.m. EDST) on AOL at "dercumchat"

"Evidently the disease is not simple obesity. If so, how are we to dispose of the nervous elements present? Equally plain is it there we have not myxoedema to deal with. ... It would seem, then, that we have here to deal with a connective-tissue dystrophy, a fatty metamorphosis of various stages of completeness, occurring in separate regions, or at best unevenly distributed and associated with symptoms suggestive of an irregular and fugitive irritation of the nerve-trunks – possibly a neuritis … Inasmuch as fatty swelling and pain are the most prominent features of the disease, I propose for it the name Adiposis Dolorosa." [From: Dercum FX. A subcutaneous connective-tissue dystrophy of the arms and back, associated with symptoms resembling myxoedema. University Medical Magazine Philadelphia, 1888; 1:140-150.]

Dercums Disease from NORD's (National Organization Of Rare Diseases)Rare Disease DatabaseDercum disease by Birger Fagher Information from the Swedish Dercumassociation

Morbus Dercum, the unknown disease by Lilian Hellgren

Generel information from the Swedish Dercumassociation

Dercum Disease by Håkan Brorson and Birger Fagher,

Information about Morbus Dercum (adipositas dolorosa) from the Swedish Dercumassociation by Berit Lindmark

Maries site about Dercums disease

Radio program "Karlavagnen" about Dercum disease with Birger Fagher, 95 12 07

Emerging Worlds

http://www.emergingworlds.com/ch_conditions_detail.cfm?vPageid=157

What is Dercum disease?

Dercum disease - also known as Adiposis Dolorosa, Anders’ syndrome and Dercum-Vitaut syndrome - is a rare condition that is characterized by multiple, painful fatty lipomas (benign, fatty tumors) that occur chiefly in post-menopausal, obese women of middle age. However, although it is 20 times more common in women, 16 percent of the reported cases are males and it can also occur in people who are not obese

The lipomas are located primarily on the trunk region and on the extremities close to the trunk. Unlike ordinary lipomas, there is also pain that can be severe and sometimes debilitating. Dercum disease is a chronic condition, meaning that it is a long lasting condition. In addition, it tends to be progressive.

What are the symptoms of Dercum disease?

This syndrome consists of four cardinal symptoms: (1) multiple, painful, fatty masses; (2) generalized obesity, usually in menopausal age; (3) weakness and fatigability; and (4) mental disturbances, including emotional instability, depression, epilepsy, confusion and dementia.

The pain can last for hours, can be paroxysmal (occurring only at certain times) or continuous, and worsens with movement. Dercum disease is often associated with generalized weakness, depression, and irritability. The condition can also be associated with early congestive heart failure, myxedema (a condition associated with severe hypothyroidism), joint pain, paroxysmal flushing episodes, tremors, cyanosis (bluish discoloration of the skin), hypertension (high blood pressure), headaches, and epistaxis (nosebleeds).

What causes Dercum disease?

The understanding of the cause and mechanism of Dercum disease remains unknown. The origin of the pain is obscure, and the disease is better known as a description of its symptoms rather than as a physiologic or metabolic process. The fatty deposits (lipomas) cause nerve compression and result in weakness and pain.

Some cases reported in the literature have suggested possible causes for Dercum disease, such as the use of corticosteroids, a disturbance of endocrine function, or a genetic cause since it seems to run in some families. Some researchers have suggested that Dercum disease is an autoimmune disorder (a condition that occurs when the body's immune system attacks normal, healthy body tissue). However, no single cause has been pinpointed.

What do we know about heredity and Dercum disease?

Dercum disease has been reported to occur in families, and in some of these cases it seems to be inherited as an autosomal dominant trait (this means that one out of a person's two copies of the gene, inherited from one parent, is altered). However, most reported cases of this condition are sporadic (the only case to occur in the family).

What is the treatment for Dercum disease?

There is no "cure" for Dercum disease. At the present time, treatment for this condition is symptomatic, meaning that it focuses on one symptom at a time rather than the whole condition. Depending on the person, options can include weight reduction, surgery for the most painful lipomas, and medications to control pain. Liposuction has been used in some cases.

NHGRI Clinical Research on Dercum Disease:

Currently, NHGRI is not conducting research on Dercum Disease

Current NHGRI Clinical Studies
Search all studies on ClinicalTrials.gov [clinicaltrials.gov]
Clinical Research FAQ

Additional Resources for Dercum Disease

Dercum's Disease [dercums_data.tripod.com]
Information, Online Chat resources, support, more.
The Dercum Society [dercumsociety.com]
Provides emotional and educational support for the women and men who live with Dercum's Disease every day.
Support group at Yahoo [health.groups.yahoo.com]
Group with about 390 members. In order to become a member you have to be registered which is done easily - and free of charge.
American Chronic Pain Association [theacpa.org]
Offering support and information for people with chronic pain.
National Foundation for the Treatment of Pain [paincare.org]
A not-for-profit organization dedicated to providing support for patients who are suffering from intractable pain, their families, friends and the physicians who treat them.
American Pain Foundation [painfoundation.org]
An independent nonprofit 501(c)3 organization serving people with pain through information, advocacy, and support.
The Mayday Pain Project [painandhealth.org]
Resources relating to pain and health.
Adiposis dolorosa (Dercum Disease) [rarediseases.info.nih.gov]
Information from the Genetics and Rare Diseases Information Center.
Finding Reliable Health Information Online
A listing of information and links for finding comprehensive genetics health information online.

The information on this page was adapted from the following resources:

eMedicine: Adiposis Dolorosa, Marjan Yousefi, M.D., Department of Dermatology, Geisinger Medical Center
NORD Guide to Rare Disorders: "Adiposis Dolorosa," Rebecca B. Campen, M.D. (2003)

Genome.Gov

http://www.genome.gov/17516629

Dr. Karen Herbst on Lipedema, Adiposis dolorosa and Dercum's Disease

Mon, 21 Sep 2009 03:47:15 GMT

Dr. Karen Herbst on Lipedema, Adiposis dolorosa and Dercum's Disease

We have had a new member of our Yahoo Lipedema global forum recently.

He name is Dr. Karen Herbst and she is not only a doctor, but is well known for her research in lipedema.

She classifies lipedema as Adipose dolorsa and Dercum's Disease.

For those who are unfamiliar with her work, or who haven't had a chance to visit her website, I urge you to do so.

Lipedema

http://www.lipomadoc.org/4222.html

also, remember that we sponsor a daily online supoort group through Yahoo groups:

Lipedema, Lipoedema, Lipodema

http://health.groups.yahoo.com/group/lipedema_lipodema_lipoedema/

Subscribe:

lipedema_lipodema_lipoedema-subscribe@yahoogroups.com

Pat

Lipedema Xanga- new articles, info and research

Mon, 21 Sep 2009 03:23:16 GMT

Lipedema Xanga - new articles, coming soon

During the collapsse of m health in the last couple years, I have had to seriously curtail so much of m inter activity.

Howsever, I seem to be entering a period of renewed vigor with many of the complications I deal with becoming better, and I am eager to launch back into my work as long as his good spell can last.

Since man doctors will miss diagnose lipedema, usually calling it either lipedemia or lipomatosis, I will be providing info pages so that visitors can see what a real difference these condtions are.

Lipedema is also called Dercum's Disease and we look into that as well.

Along the way, I'll continue to search out various other tid bits that hopefully will be both helpful and hope.

Pat

Lipomatosis-associated inflammation and excess collagen may contribute to lower relative resting ene

Fri, 18 Sep 2009 22:19:39 GMT

Lipomatosis-associated inflammation and excess collagen may contribute to lower relative resting energy expenditure in women with adiposis dolorosa

Int J Obes (Lond). 2009 Sep

Herbst KL, Coviello AD, Chang A, Boyle DL.

Department of Medicine, University of California San Diego, San Diego, CA, USA. karen.herbst@va.gov

Correspondence: Dr KL Herbst, Medicine/Endocrinology, University of California, San Diego and VA San Diego Healthcare System, 3350 La Jolla Village Drive, MC 9–111-G, San Diego, CA 92161, USA. E-mail: karen.herbst@va.gov

Received 9 June 2008; Revised 8 May 2009; Accepted 12 May 2009; Published online 21 July 2009.

BACKGROUND: Adiposis dolorosa (AD) is a syndrome of obese and non-obese individuals whose hallmark is lipomatosis: unencapsulated painful fatty masses in subcutaneous fat. Lipomatosis may contain excess collagen and multi-nucleated giant (MNG) cells. Case reports suggest metabolic defects in AD.

OBJECTIVES: (1) To determine whether women with AD have altered relative resting energy expenditure (REE per total body mass) compared with controls; and (2) to quantitate lipomatosis-associated collagen, MNGs and tissue and blood cytokines that may influence REE.

METHODS: A total of 10 women with AD were compared with age, body mass index, fat and weight-matched control women. Adipose tissue was obtained from five women with AD and five controls and evaluated for collagen and macrophages/MNGs. Fat mass and fat-free mass were identified by dual X-ray absorptiometry. REE was by determined indirect calorimetry and related to mass. Adipokines and cytokines were evaluated in blood and tissue.

RESULTS: Relative REE (REE per total body mass) was lower in women with AD compared with controls (P=0.007). Only lipomatosis (group) and total body mass were significant predictors of REE in forward stepwise regression (P<0.0001). Adipose interleukin (IL)-6 levels were elevated (P=0.03) and connective tissue was increased fourfold in lipomatosis compared with control tissue (P <0.0001). There was no difference in adipose tissue macrophages between groups; 30% of women with AD had MNG cells. Anti-inflammatory IL-13 levels were elevated (P=0.03), and cytokines important in the recruitment of monocytes, Fraktalkine (P=0.04) and macrophage inflammatory protein-1beta (P=0.009), were significantly lower in the blood of women with AD compared with controls.

CONCLUSIONS: The lower relative REE in women with AD compared with controls was associated with increased connective (non-metabolic) tissue in the lipomatosis, and inflammation, although underlying metabolic defects may be important as well. Understanding the pathophysiology and metabolism of lipomatosis in AD may contribute to a better understanding of metabolism in non-lipomatosis obesity.

International Journal of Obesity

http://www.nature.com/ijo/journal/v33/n9/abs/ijo2009119a.html

Adipose tissue engineering: state of the art, recent advances and innovative approaches.

Fri, 18 Sep 2009 21:57:29 GMT

As we know, lipedema invovles fat tissue and it's incorrect development, waist down on lipedema patients. This condition which is generally thought of as involving several genetic families. This interesting article is on the manipulation of fat cell growth.

I wanted to share it for a couple reasons.

First, to give further encouragement that research on adipose tissue is on-going and this type of research is not only critical, but will help lead the pathway to understanding lipedema and a cure.

Pat

Adipose tissue engineering: state of the art, recent advances and innovative approaches.

Expert Rev Med Devices. 2009 Sep

Tanzi MC, Farè S.

Biomaterials Laboratory, Department of Bioengineering, Politecnico di Milano, 32 Piazza L da Vinci, 20133 Milano, Italy. mariacristina.tanzi@polimi.it

Adipose tissue is a highly specialized connective tissue found either in white or brown forms, the white form being the most abundant in adult humans. Loss or damage of white adipose tissue due to aging or pathological conditions needs reconstructive approaches. To date, two main strategies are being investigated for generating functional adipose tissue: autologous tissue/cell transplantation and adipose tissue engineering. Free-fat transplantation rarely achieves sufficient tissue augmentation owing to delayed neovascularization, with subsequent cell necrosis and graft volume shrinkage. Tissue engineering approaches represent, instead, a more suitable alternative for adipose tissue regeneration; they can be performed either with in situ or de novo adipogenesis. In situ adipogenesis or transplantation of encapsulated cells can be useful in healing small-volume defects, whereas restoration of large defects, where vascularization and a rapid volumetric gain are strict requirements, needs de novo strategies with 3D scaffold/filling matrix combinations. For adipose tissue engineering, the use of adult mesenchymal stem cells (both adipose- and bone marrow-derived stem cells) or of preadipocytes is preferred to the use of mature adipocytes, which have low expandability and poor ability for volume retention. This review intends to assemble and describe recent work on this topic, critically presenting successes obtained and drawbacks faced to date.

Expert Review

http://www.expert-reviews.com/doi/abs/10.1586/erd.09.37?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dncbi.nlm.nih.gov

Familial Sotos syndrome caused by a novel missense mutation, C2175S, in NSD1 and associated with nor

Mon, 29 Jun 2009 10:31:09 GMT

Familial Sotos syndrome caused by a novel missense mutation, C2175S, in NSD1 and associated with normal intelligence, insulin dependent diabetes, bronchial asthma, and lipedema.

Eur J Med Genet. 2009 Jun 19

Zechner U, Kohlschmidt N, Kempf O, Gebauer K, Haug K, Engels H, Haaf T, Bartsch O.

Institute of Human Genetics, Johannes Gutenberg University Mainz, Mainz, Germany.

We report a familial Sotos syndrome in two children, boy and girl, aged 17 and 8 years, and in their 44 year old mother, who displayed normal intelligence at adult age, but suffered from insulin dependent diabetes mellitus, bronchial asthma, and severe lipedema. The underlying missense mutation, C2175S, occurred in a conserved segment of the NSD1 gene. Our findings confirm that familial cases of SS are more likely to carry missense mutations. This case report may prove useful to avoid underestimation of the recurrence rate of SS, and to demonstrate that the developmental delay may normalize, enabling an independent life and having an own family.

Elsevier Science Direct

Massive localized lipolymphedema pseudotumor in a morbidly obese patient.

Mon, 29 Jun 2009 10:22:21 GMT

Massive localized lipolymphedema pseudotumor in a morbidly obese patient.

Lymphology. 2006 Dec

Jensen V, Witte MH, Latifi R.

Department of Surgery, University of Arizona College of Medicine, Tucson, Arizona 85724-5063, USA.

We describe a 31 year old man with a massive localized tumor-like lipolymphedema, (lipedema) a puzzling entity that afflicts the morbidly obese. The 281 kg man presented with a growing ulcerated bleeding mass located on his proximal medial thigh and suspicious for sarcoma. After en bloc resection of the 28.2 kg edematous mass, no evidence of neoplasm was found, only prominent lymphatic vessel dilation and edema with large quantities of unremarkable adipose and connective tissue. The lesion conformed to the diagnostic criteria for massive localized lipolymphedema (MLL) pseudotumor.

PMID: 17319630 [PubMed - indexed for MEDLINE]

Adipose tissue remodeling in lipedema: adipocyte death and concurrent regeneration.

Sat, 23 May 2009 13:35:15 GMT

Adipose tissue remodeling in lipedema: adipocyte death and concurrent regeneration.

J Cutan Pathol. 2009 Mar

Suga H, Araki J, Aoi N, Kato H, Higashino T, Yoshimura K.

Department of Plastic Surgery, University of Tokyo Graduate School of Medicine, Tokyo, Japan.

Lipedema is a disease with unknown etiology presenting as bilateral and symmetric enlargement of the lower extremities due to subcutaneous deposition of the adipose tissue. Here we describe the histopathological features of the lipedema tissue and nonaffected adipose tissue obtained from a typical patient with severe lipedema. Immunohistochemical analyses indicated degenerative and regenerative changes of the lipedema tissue, characterized by crown-like structures (necrotizing adipocytes surrounded by infiltrating CD68+ macrophages; a feature commonly seen in obese adipose tissue) and proliferation of adipose-derived stem/progenitor/stromal cells (Ki67+CD34+ cells), respectively. These findings suggested increased adipogenesis in the lipedema tissue, which may further lead to hypoxia similar to that seen in obesity, resulting in adipocyte necrosis and macrophage recruitment. The confinement to the lower extremities and the difference from systemic obesity warrants further elucidation in future studies. Suga H, Araki J, Aoi N, Kato H, Higashino T, Yoshimura K. Adipose tissue remodeling in lipedema: adipocyte death and concurrent regeneration.

Wiley InterScience

Complex decongestive physiotherapy decreases capillary fragility in lipedema.

Tue, 19 May 2009 00:25:01 GMT

Complex decongestive physiotherapy decreases capillary fragility in lipedema.

Lymphology. 2008 Dec

Szolnoky G, Nagy N, Kovács RK, Dósa-Rácz E, Szabó A, Bársony K, Balogh M, Kemény L.

Department of Dermatology and Allergology, University of Szeged, Hungary. szolnoky@dermall.hu

Lipedema is a disproportional obesity featuring frequent hematoma formation due to even minor traumatic injuries. On the basis of clinical observations, complete decongestive physiotherapy diminishes the incidence of hematomas due to minor injuries beyond leg volume reduction. Hematoma development may be caused by altered capillary resistance (CR) or altered capillary fragility (CF). We measured capillary fragility (CF) before and after complex decongestive physiotherapy (CDP) to examine, whether CDP could reduce CF. 38 women with lipedema were included in the study. Twenty-one (21) patients were treated with CDP and 17 using exclusively moisturizers as the control group. CDP comprised once daily manual lymph drainage, intermittent pneumatic compression and multilayered short-stretch bandaging performed throughout a 5-day-course. CF was evaluated with the vacuum suction method (VSM) using Parrot's angiosterrometer in both groups.

Decongestive therapy resulted in a significant reduction of the number of petechiae while no change was detected within the control group.

Complete decongestive physiotherapy significantly reduced CF in patients with lipedema and this reduction may lead to reduced hematoma formation.

PMID: 19306662 [PubMed - indexed for MEDLINE]