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Lipodystrophy

Lipodystrophy (synonymous with lipoatrophy) is a disease manifested by atrophy of subcutaneous fatty tissue on the head, neck, upper half of the body with excessive accumulation of fat in its lower half. It is rare, affects mainly women. The etiology is unclear. Internal organs are not affected, their function is not impaired. Patients go to the doctor because of their appearance, sometimes complain of weakness, irritability. Life prognosis is favorable. There is no causal treatment; they use nerve-strengthening agents and vitamins.

Lipodystrophy (Greek. Lipos - fat + dystrophy; synonym lipoatrophy) - atrophy of adipose tissue of certain areas or areas of the body, for example on one side of the body with spondylitis, in the orbit with traumatic enophthalmos, at the injection sites of insulin (insulin lipodystrophy).

The most important form of lipodystrophy is progressive lipodystrophy (synonym: lipodystrophia progressiva, lipodystrophia cephalothoraciea progressiva, Barracker-Simons disease) - the disappearance of subcutaneous fat on the head, neck and chest. The disease is rare, usually in women, and appears since childhood. The process begins with a face slimming, then it spreads to the waist. In the lower half of the body, subcutaneous fatty tissue is developed normally, and often even excessively. The etiology and pathogenesis of progressive lipodystrophy are not clear. There are indications of the role of endocrine disorders (thyrotoxicosis, dysfunction of the pituitary), hereditary constitutional factors. The main significance in the pathogenesis is attached to disorders of trophic innervation associated with damage to the medial brain, spinal cord and sympathetic ganglia.

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Patients complain of weakness, chilliness, nervousness. Attention is drawn to the discrepancy between the depletion of the upper torso and the lower obesity. Face with a sharp depletion recalls the "mask of the dead." Sometimes there are trophic changes in the skin, nails, as well as hypertrichosis, acrocyanosis, polyuria, glycosuria. The disease progresses in the initial period; reaching the maximum spread, the process stabilizes. Sometimes progression gives way to long-term remission.

The prognosis for life is favorable, but it is not possible to stop the increase in fat tissue atrophy with therapeutic measures, including enhanced nutrition. There are indications of a favorable result of insulin therapy in small doses. Treatment - fortifying, symptomatic, vitamin therapy.

Lipodystrophy (Barraquer – Simmons disease) is an atrophy of adipose tissue in the upper half of the body with increased deposition of fat in the lower half of the body, mainly in the thighs and abdomen, sometimes inverse relationships in the distribution of adipose tissue are also possible. Atrophy or hemiatrophy of the facial muscles is possible.

The disease can occur in childhood, during puberty or after reaching puberty. Women are usually ill.

The etiology and pathogenesis are not clear. Probably, the basis of the disease is the defeat of diencephalic vegetative formations that regulate trophic effects.

The flow is progressive. Usually only one half of the body atrophies.

With the addition of weight, fat still accumulates only in the subcutaneous tissue of the lower half of the body. Often marked trophic changes in the skin, bones, hair, hyperhidrosis, acrocyanosis.

Patients complain of fatigue, lethargy, irritability, and chilliness. Amenorrhea may occur.

The prognosis for recovery is not favorable.

Prevention and effective treatment methods are not known.

In addition to progressive lipodystrophy, there is a local-atrophic form of lipodystrophy, which consists in the atrophy of the subcutaneous tissue in patients with diabetes mellitus at the sites of insulin administration.

With the development of local lipodystrophy, it is recommended to frequently change the place of insulin administration.