This usually refers to a loss of fat from the subcutaneous fat layer;
subcutaneous fat is found immediately underneath the skin; a loss of
subcutaneous fat leads to an increased definition of the muscle and
bone structures underneath and presents itself as one or more depressions
in the skin; if all, or most, of the underlying muscle and bone structures
are affected, it is called Panatrophy.
Congenital And Acquired Lipodystrophy:
Lipodystrophy may be Congenital, which means the tendency to lose fat
is present at birth, or it can be Acquired, which means the loss of
fat occurs later in life; Lipodystrophy can affect all of the body,
which is known as Generalised Lipodystrophy, or just parts of the body,
which is known as Partial Lipodystrophy.
Acquired Lipodystrophy is the most common form of Lipodystrophy
and is caused by:
1 - Steroid Injections, where a dent due to localised
fat loss may appear at the site of the injections; this can be avoided
by simply making sure that the injection is within the muscle tissue
and not in the subcutaneous fat.
2 - Insulin Injections,
where a dent due to localised fat loss may appear at the site of regular
injections; this can be avoided by simply making sure that the injections
are made in several sites, rather than just one or two.
3 - Other Injections of Penicillin, Iron, Growth Hormone,
Vaccines and even the use of Acupuncture needles, where a dent due to
localised fat loss may appear at the site of regular injections; these
can be avoided by obtaining and following advice from your healthcare
N.B. A similar problem known as Lipohypertrophy is
caused by repeatedly injecting Insulin into the same small area, resulting
in a build up of lumps under the skin, rather than a loss of fat; this
can result in an erratic absorption of insulin and can be unsightly.
This is a term used for inflammation of subcutaneous fat; it is sometimes
followed by a permanent loss of fat; this type of Fat atrophy is particularly
likely in Lupus Panniculitis 'Lupus Profundus' and some forms of Morphoea,
which is a rare condition also known as Localized Scleroderma and is
characterised by patches of red or purple skin that appear mainly on
the torso, arms and legs.
Progressive Hemifacial Atrophy 'Parry-Romberg Syndrome':
This is characterised by a thinning of skin, fatty tissue and underlying
bony structures of one side of the face; onset is usually during childhood
and the cause is unknown.
Generalised Acquired Lipodystrophies are rare and they include:
Generalised Lipodystrophy known as the 'Lawrence Syndrome' is a rare
disorder with a loss of fat during childhood and adolescence; females
are affected more often than males; it may occur following infections
such as chicken pox, measles and whooping cough; it is often associated
with the elevation of blood cholesterol and Diabetes.
Partial Lipodystrophy known as the 'Barraquer-Simons Syndrome' usually
occurs around 10 years of age after a viral illness; fat is lost from
the face and trunk, but the legs and hips are spared; fat may accumulate
in the legs and hips in women; females are affected three times more
often than males; one third of patients also develop kidney disease;
it is also associated with auto immune disorders including Systemic
Lupus Erythematosus, Hypothyroidism and Rheumatoid Arthritis.
Lipodystrophy is also associated with The Human Immunodeficiency Virus
(HIV) and is brought on by the long term treatment of antiretroviral
drugs; the exact mechanism is unknown, but fat is lost from the face,
arms, legs and buttocks; fat may accumulate on the neck and upper back.
Congenital Lipodystrophy can be generalised
or partial and like many cases of Acquired Lipodystrophy, the cause
is unknown; though, recent scientific advances have identified some
Generalised Congenital Lipodystrophy known
as the 'Berardinelli-Seip Syndrome' is a rare disorder with gene mutations
of the Seipin or AGPAT2 gene; it is characterised by high levels of
Insulin (due to Insulin Resistance) and high levels of blood fats; it
results in gigantism (Acromegaly), enlarged liver and kidneys, Pancreatitis,
Acanthosis Nigricans and increased body hair (Hypertrichosis), as well
as a generalised loss of body fat.
Partial Congenital Lipodystrophy is associated
with the metabolic Syndrome X and includes Hypertension, Insulin Resistance,
Diabetes and Severe Hypertriglyceridemia resulting in Pancreatitis and
Premature Coronary Artery Disease; sometimes a partial loss of fat results
in other areas of fat enlarging to compensate; it spares the face and
is inherited as an Autosomal Dominant Disorder, it is likely that half
of the children of an affected individual will also be affected.
There are two subtypes, Type 1 is known as the 'Kobberling Syndrome'
and results in a fat loss from the extremities and Central Obesity;
so far it has only affected females; Type 2 is known as the 'Dunnigan
Syndrome' and results in a fat loss from the extremities, abdomen and
thorax; this is due to a mutation of the Lamin A/C gene or PPAR gamma
gene, which is part of the nuclear membrane within the cell; mutations
in this gene can result in a variety of other rare diseases including
Muscular Dystrophy, Cardiomyopathy, Neuropathy and Progeria and are
collectively termed Laminopathies.
Treatments for these conditions depends on the cause of the Lipodystrophy
and can include the moving of fat from one part of the body to another
using flaps and grafts, injectable filers and implants.
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