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Review
. 2018 Dec;15(6):921-928.
doi: 10.1111/iwj.12949. Epub 2018 Jun 29.

Lipoedema is not lymphoedema: A review of current literature

Eran Shavit  1 , Uwe Wollina  2 , Afsaneh Alavi  1
Affiliations
Review

Lipoedema is not lymphoedema: A review of current literature

Eran Shavit et al. Int Wound J. 2018 Dec.

Abstract

Lipoedema is a rare painful disorder of the adipose tissue. It essentially affects females and is often misdiagnosed as lymphoedema or obesity. It is globally misdiagnosed or underdiagnosed, and the literature is lacking appropriate guidance to assist clinicians towards this diagnosis. However, the need to recognise this disorder as a unique entity has important implications to establish proper treatment and, therefore, its tremendous effect on patients. Early diagnosis and treatment can turn these patients' lives upside down. The aim of this review is to focus on the clinical guidance, differential diagnosis, and management strategies. In addition, other aspects of lipoedema, including epidemiology and pathogenesis, are also being discussed here. Lipoedema is distinct from obesity and distinct from lymphoedema, although it might progress to involve the venous and lymphatic system (venolipedema or lympholipedema or both). Late diagnosis can leave the patient debilitated. Management of lipoedema includes weight loss, control of oedema, complex decongestive physiotherapy, liposuction, and laser-assisted lipolysis. However; there are increasing reports on tumescent liposuction as the preferred surgical option with long-lasting results. The role of more randomised controlled studies to further explore the management of this clinical entity remains promising.

Keywords: lipoedema; lymphoedema; lympholipedema (in German lipo-lymphedema); tumescent liposuction.

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Conflict of interest statement

No conflict of interest was declared.

Figures

Figure 1
Figure 1
Stages of lipoedema. (From left to right) stages I‐II‐III [Colour figure can be viewed at wileyonlinelibrary.com]
Figure 2
Figure 2
Differential diagnosis: (from left to right) unilateral lymphedema (notice the asymmetry), venolipoedema‐notice the “ankle pad” sign is prominent (also secondary changes of lipodermatosclerosis), acute lipodermatosclerosis and chronic lipodermatosclerosis (right picture)‐notice the sharp margination and sparing of the feet [Colour figure can be viewed at wileyonlinelibrary.com]
Figure 3
Figure 3
Lipoedema diagnostic algorithm (and approach to enlargement of lower extremities) [Colour figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

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