Figure 4 - uploaded by Hamideh Moravvej
Content may be subject to copyright.
Source publication
Lipedematous alopecia and lipedematous scalp are two similar unusual conditions mostly affecting healthy black women. Here, we report one such case with emphasis on clinical and histologic findings, and review the literature on the subject. The presence of ecstatic lymphatic vessels with hair loss was particularly emphasized. Our findings suggest a...
Context in source publication
Context 1
... dermal lymphatic vessels were significantly dilated, and increased thickness of the subcutaneous adipose tissue and decreased number of hair follicles were reported (Figure 3). The subcutaneous adipose tissue showed mild edema and dilated lymphatic vessels (Figure 4). No mucin deposits were identified. ...
Similar publications
Erosive pustular dermatosis of the scalp (EPDS) is a rare disorder of the elderly characterized by multiple pustular lesions with erosions and crusting that result in scarring alopecia. EPDS typically develops in aged or sun-damaged skin with a history of trauma. Histopathologically, EPDS is nonspecific, showing atrophic epidermis and chronic infla...
Citations
... LA is characterized by a thick and boggy scalp showing varying degrees of hair loss, mostly because of increased subcutaneous fatty tissue thickness. If no hair abnormalities are present, the condition is called lipedematous scalp (LS) 3 . The swelling can slowly progress to adjacent areas; hair loss, if present, results in diffuse or patchy alopecia 2 . ...
Lipedematous alopecia is a rare condition of unknown etiology characterized by a thick boggy scalp with varying degrees of hair loss. It is usually seen in adult African-American females, and a case in a 9-year-old was the youngest patient reported thus far. We report on the appearance of this condition in two children, a 6-year-old child and a 10-year-old child. Each presented with congenital patchy hair loss on the occipital area and the left temple. A boggy hairless scalp with soft swelling was detected in both patients. Histological examination showed increased thickness of the subcutaneous fat tissue with a decrease in hair follicles. These features were consistent with a diagnosis of lipedematous alopecia. We report two cases of congenital lipedematous alopecia, which has not been reported previously. Although congenital, these distinct clinical features should be kept in mind in the diagnosis of alopecic hair loss.
... Lipoedematous scalp and lipoedematous alopecia were initially described in healthy African-American women, but the role of racial and gender factors have been lessened with reports of these conditions occurring in non-African women and men within the last decade. [1][2][3][4][5] There is no effective treatment available to alleviate symptoms and discomfort. We report a case of lipoedematous alopecia treated successfully with surgical excision. ...
... Hairs that continue to grow often break off easily and do not exceed 2 cm in length. 8 Disturbances of hair growth could occur as a result of the presence of lymphangiectasias, 4 or as a result of oedema, 6 or the fat itself might invade and destroy the follicle. We can only speculate on the role of fat and its effects on hair growth as the mechanism of hair loss in lipoedematous alopecia. ...
A 67-year-old Caucasian woman presented with an area of alopecia over the right occipital scalp, which had slowly expanded over the last 10 years. The skin beneath the alopecia felt soft and boggy although the epidermis looked unremarkable. Ultrasound showed thickening of the underlying subcutaneous tissue. Scalp histology showed enlarged fat lobules within the subcutis that infiltrated along fibrous tracts into the mid-dermis. There was a complete loss of hair follicles. These findings were consistent with lipoedematous alopecia of the scalp. Surgical debulking with scalp reduction produced an acceptable result in our patient with no evidence of relapse after 12 months.
This chapter addresses principally non‐inflammatory acquired disorders of subcutaneous fat with an emphasis on acquired lipodystrophy, fat hypertrophy, subcutaneous lipomatosis and lipoedema. Acquired lipodystrophy may be associated with other medical conditions and may occur as a result of antiretroviral therapy, total body irradiation or haematopoietic stem cell transplant, or injection of medications. Some of the subcutaneous lipodermatoses may have a genetic component. Also included in the discussion are conditions such as cellulite and skin conditions related to obesity. For each of these acquired disorders, relevant pathophysiology, methods of diagnosis and management options are discussed.
This chapter addresses principally non‐inflammatory acquired disorders of subcutaneous fat with an emphasis on acquired lipodystrophy, fat hypertrophy, subcutaneous lipomatosis and lipoedema. While some of the entities discussed are very common, such as cellulite and obesity, most are much rarer. Panniculitis and genetic disorders of subcutaneous fat are addressed other chapters in the book.
An 11-year-old girl applied for having a spongy consistency of swellings in various part of her scalp. The overlying skin and hair growth of these areas appeared normal. There was no evidence of systemic disease except for exogenous obesity. Ultrasonography showed thickening of the subcutaneous tissue on the swelling part of the scalp. Histopathological examination revealed elastic fibre fragmentation on dermis and increased thickness in the subcutaneous fat tissue containing numerous hair follicles. The clinical features and the histopathological changes in the lesion were consistent with a diagnosis of lipedematous scalp, which has previously been described predominantly in adult women.
A case of lipedematous scalp complicated by lipedematous alopecia is reported. A 53-year-old woman presented with a 3-month history of gradual swelling and diffuse hair thinning and alopecia, more prominent along the vertex and parietal regions. The biopsy from the vertex revealed a normal epidermis, with diffuse loss of hair follicles, subcutaneous tissue thickening that even extended to the dermis. Alcian blue stains revealed no mucin deposits. Echography showed thickening of subcutaneous tissue at the vertex region.
Lipedematous alopecia is an uncommon disease that mainly affects African American and Egyptian women. This report is of an 18-year-old Taiwanese woman who presented with asymptomatic boggy and thickened scalp for 10 years. In the last 6 months, there was diffuse hair loss on the affected scalp without scarring. Histopathologically, there were increased thickness of subcutaneous fat layer, mild perivascular lymphocytic infiltration, and separated collagen bundles in the dermis. Alcian blue stain demonstrated mucin deposition in the dermis and subcutis, whereas magnetic resonance imaging showed thickened scalp with expanded subcutaneous fat layer. The clinical findings and imaging study established the diagnosis of lipedematous alopecia. The pathogenesis and disease etiology remain unclear. The coexistence of mucin is extremely rare and its significance should be further investigated.
Little is known about lipedematous scalp (LS) and lipedematous alopecia (LA). We investigated the clinical and histopathological features of LS and LA with a 7-year retrospective re-evaluation of 31 patients. 23 cases were LS and 8 LA, with 25 females and 6 males. The overweight and obese groups contained 15 patients with 16 within the normal weight range. Scalp thickness varied between 9-18 mm in our patients by magnetic resonance imaging. Thickening of the subcutaneous adipose tissue layer was present in all cases. Dermal edema was seen in 22 patients, lymphatic dilatation in 17 and elastic fiber fragmentation in 21. When the relationship between dermal edema and elastic fibers was investigated, elastic fiber fragmentation was found in 86.4% of cases with dermal edema. Collagen fragmentation and coarsening were seen in two cases, and collagen was normal in 24 cases. The number of follicles was decreased in 9 cases and normal in 17. The clinical and histopathological findings were not statistically different between LS and LA groups (p>0.05). The majority of the patients in our study were females, suggesting an underlying hormonal pathology. The association with obesity suggested that anatomical differences can be present in lipid distribution. Dermal edema and lymphatic dilatation suggested the primary pathology is lymphatic system.
