Lipoedema

Lipoedema is a chronic disorder, involving accumulation of adipose tissue in the subcutaneous layer of skin. This disease occurs almost exclusively in women. The defining characteristic of this disease is the bilateral, symmetrical enlargement of the limbs, usually both legs. It is usually triggered following puberty but can also occur post-pregnancy, at peri-menopause,or after gynecological surgery.

The incidence of lymphedema around the world is estimated to be 140 million. As many as 40 million exhibit symptoms of Lymphatic Filariasis (LF) disease, including lymphedema, elephantiasis, and hydrocele. Until the past decade, lymphoedema received little clinical attention and had been termed “the hidden epidemic”. The real number is probably higher due to insufficient diagnosis.
The true risk factor profile is not known. There may be many factors that predispose an individual to developing lymphoedema or that predict the progression, severity and outcome of the condition.
India constitutes approximately 45% of the world's burden of LF. In India, Lymphoedema is a major problem and despite a fall in the incidence of filariasis, the incidence of Lymphoedema is rising due to other causes such as cancer, trauma and venous diseases, etc. Since the disease is chronic and relentless, management of this disease has to be for life.
Lymphoedema can affect people of all ages. It can be congenital or can develop as a result of cancer or its treatment or due to trauma or chronic infection. It can occur in a limb or limbs or in the head and neck, trunk or genital area. It may not become apparent for some time after trauma (e.g. cancer surgery) and patients remain at risk of developing clinical lymphoedema at a later stage.
One point to note is that, oedema arising from venous insufficiency is not the same as lymphoedema. However, untreated venous insufficiency can lead to a combined venous/lymphatic disorder, which is treated much the same way as lymphoedema.

Causes of Lipoedema

As the onset of lipoedema coincides with the time of hormonal imbalance, a genetic or hormonal involvement is suspected but the exact cause in unknown.

Stages of Lipoedema

Stage I	The skin has a normal appearance, with a soft and smooth surface
Stage II	Fatty nodules are formed, making the skin surface hard and uneven.
Stage III	Large fatty lobules are formed, leading to significant deformation of the skin