title: Pathophysiological dilemmas of lipedema.
abstract: Lipedema is a common, but often underdiagnosed masquerading disease of obesity, which almost exclusively affects females. There are many debates regarding the diagnosis as well as the treatment strategies of the disease. The clinical diagnosis is relatively simple, however, knowledge regarding the pathomechanism is less than limited and curative therapy does not exist at all demanding an urgent need for extensive research. According to our hypothesis, lipedema is an estrogen-regulated polygenetic disease, which manifests in parallel with feminine hormonal changes and leads to vasculo- and lymphangiopathy. Inflammation of the peripheral nerves and sympathetic innervation abnormalities of the subcutaneous adipose tissue also involving estrogen may be responsible for neuropathy. Adipocyte hyperproliferation is likely to be a secondary phenomenon maintaining a vicious cycle. Herein, the relevant articles are reviewed from 1913 until now and discussed in context of the most likely mechanisms leading to the disease, which could serve as a starting point for further research.
authors.affiliation: Department of Dermatology and Allergology, University of Szeged, Faculty of Medicine, Koranyi fasor 6-8, 6720 Szeged, Hungary. Electronic address: szeledit@hotmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Szél
authors.affiliation: Department of Dermatology and Allergology, University of Szeged, Faculty of Medicine, Koranyi fasor 6-8, 6720 Szeged, Hungary.
authors.forename: L
authors.initials: L
authors.lastname: Kemény
authors.affiliation: Department of Dermatology and Allergology, University of Szeged, Faculty of Medicine, Koranyi fasor 6-8, 6720 Szeged, Hungary.
authors.forename: G
authors.initials: G
authors.lastname: Groma
authors.affiliation: Department of Dermatology and Allergology, University of Szeged, Faculty of Medicine, Koranyi fasor 6-8, 6720 Szeged, Hungary.
authors.forename: G
authors.initials: G
authors.lastname: Szolnoky
mesh_terms: D017667:Adipocytes / Q000166:cytology*; D000273:Adipose Tissue; D049109:Cell Proliferation; D004967:Estrogens / Q000737:chemistry*; D005260:Female; D020022:Genetic Predisposition to Disease; D006728:Hormones / Q000737:chemistry; D006801:Humans; D007249:Inflammation; D007866:Leg / Q000098:blood supply; D065134:Lipedema / Q000235:genetics* / Q000503:physiopathology*; D008055:Lipids / Q000097:blood; D008297:Male; D008955:Models, Cardiovascular; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications; D017933:Peripheral Nervous System; D013564:Sympathetic Nervous System
chemical_list: D004967:Estrogens; D006728:Hormones; D008055:Lipids