The following symptoms and complaints may indicate lipedema:
- Bilateral (bilateral) symmetrical, dysproportional adipose tissue hypertrophy (circumferential increase due to excessive enlargement (hypertrophy) of subcutaneous adipose tissue)
- Exclusion of the hands and feet (“cuff phenomenon”).
- Involvement of the arms in about 30% of cases.
- Feeling of heaviness and tension of the affected extremity.
- Significant sensitivity to pressure and touch (allodynia/pain sensation triggered by stimuli that usually do not cause pain).
- Negative Stemmer’s sign:
- Positive Stemmer’s sign: When the skin fold over the second and third toes or fingers is widened, thickened, and difficult or impossible to lift off → sign of lymphedema.
- Tendency to hematomas (bruises) in the affected areas, spontaneously or with trivial trauma.
- Hypothermia of the skin (cold skin).
- Teleangiectasias (irreversibly dilated capillary vessels of the skin) and lipodepots.
- Stable limb circumference
- Even after elevation or weight loss (caloric restriction).
- Increased swelling in summer
- Symptom intensification during the day
- Skin surface:
- Finely knotty skin surface (colloquially: orange peel skin; synonyms: cellulite; dermopanniculosis deformans, or erroneously cellulitis).
- Coarse-knotted skin surface with larger dents (medically also “mattress phenomenon”).
- Large, deforming skin flaps and bulges
- Possibly also lipolymphedema with with increased orthostatic edema formation (water retention) in the back of the hands and feet and fingers and toes (see under classification “Severity”) lymphedema on the fingers and toes or on the back of the hands and feet show the already occurred decompensation of the not (sufficiently) treated lipedema, primarily a local lymphedema develops in the subcutaneous adipose tissue
Further notes
- The lower extremities are predominantly affected; in about 30% of cases, characteristic changes are also seen in the arms.
- Lipid edema affecting only the upper extremities is very rare.
- Calorie reduction has no effect on lipedema.
