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Causes of Lipodystrophy or Lipoatrophy

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Overview
Autoimmune
Dermatomyositis
Electromagnetic Fields?
Gluten Sensitivity
Lupus
Panniculitis
Scleroderma
Sjogren's Syndrome
Thyroiditis

This page covers only localized lipodystrophy
that is caused by things other than AIDS/HIV or retroviral treatments.

Overview

Causes of lipodystrophy, other than HIV/Aids and retroviral treatment, include autoimmune diseases, dermatomyositis, diabetes, electromagnetic fields, gluten sensitivity, lupus, panniculitis, scleroderma, Sjogren's, and thyroiditis. (Also see Lipodystrophy)

Autoimmune Diseases

Localized Lipoatrophy can be a common sequela of panniculitis in patients with connective tissue diseases (eg, systemic lupus erythematosus, subcutaneous morphea, the syndrome of lobular lymphocytic connective tissue panniculitis of Winkelmann and Padilha-Goncalves). Lipoatrophy can be associated with nephritis, hypocomplementemia, scleroderma, Sjögren's syndrome, recurrent pyogenic infections, immune thrombocytopenic purpura (ITP), and thyroiditis. Medscape.

Lipodystrophy, Acquired Partial. Disorders associated with acquired partial lipodystrophy include membranoproliferative glomerulonephritis, and autoimmune diseases including (but not limited to) systemic lupus erythematosus, dermatomyositis, pernicious anemia, celiac disease, dermatitis herpetiformis, rheumatoid arthritis, temporal arteritis, leukocytoclastic vasculitis, POEMS, and diabetes. Medscape.

Primary Atrophic Solitary Morphea Profunda. Here, we describe a patient presenting with noninflammatory cupuliform (shaped like a small cup) depressed plaques, without any significant skin induration, pigmentation or texture change, that appeared on the left shoulder at a site of previous intramuscular vaccination. Our observation highlights the wide spectrum of clinical presentations of localized scleroderma. The latter should be considered in the presence of lipoatrophy-like lesions for proper workup and therapy. (Also see Causes of Scleroderma: Vaccinations and Morphea Profunda)

Dermatomyositis

Lipodystrophy may be a cutaneous marker for metabolic abnormalities in dermatomyositis.

Diabetes

Lipoatrophic diabetes mellitus can cause lipoatrophy.

Electromagnetic Fields?

Lipoatrophia Semicircularis: a new office disease? 900 cases reported in Belgium. Since 1995, we have diagnosed more than 900 cases in our company. Based on our research, we believe that electromagnetic fields play an important role in this phenomenon. Curvers Bart, MD, ESD Journal.

Gluten Sensitivity

Dermatomyositis associated with celiac disease: response to a gluten-free diet. After she was put on a strict gluten-free diet, both nutritional deficiencies and the dermatomyositis resolved. The patient's human leukocyte antigen haplotype study was positive for DR3 and DQ2, which have been shown to be associated with both juvenile dermatomyositis and celiac disease. It is suggested that patients with newly diagnosed dermatomyositis be investigated for concomitant celiac disease even in the absence of gastrointestinal symptoms. Can J Gastroenterol. 2006 Jun;20(6):433-5. (Also see: Celiac Disease and Gluten Sensitivity)

Lupus

Partial Lipodystrophy in a Patient with Systemic Lupus erythematosus. A 54-year-old woman developed partial lipodystrophy on the left side of her face. She had been suffering from systemic lupus erythematosus (SLE) since 1985 when she was 45 years old. Dermatology 2002;204:298-300.

Semicircular lipoatrophy in a child with systemic lupus erythematosus after subcutaneous injections with methotrexate. We report a 10-year-old girl who developed semicircular lipoatrophy on the anterior thighs after treatment of systemic lupus erythematosus (SLE) with subcutaneous injections of methotrexate. Pediatr Dermatol. 2002 Sep-Oct;19(5):432-5.

Panniculitis

Panniculitis. Panniculitis is inflammation of the subcutaneous fat. Fat is divided into lobules by connective tissue septae. These septae contain the blood supply supplying the lobule. Chart lists type of infiltrates associated by diseases, including lipoatrophy. The Doctor's Doctor.

Connective tissue panniculitis: lupus panniculitis, dermatomyositis, morphea/scleroderma.These subtypes of panniculitis are unified by an active inflammatory stage of the disease that can progress to develop scarring, atrophy, and calcifications. CB Hansen (PubMed) Dermatol Ther, 2010 Jul-Aug;23(4):341-9.

Lipodystrophy and connective tissue panniculitis. The case describes an acquired lipodystrophy with accompanying diabetes mellitus and positive autoantibodies. This association without clinical features of connective tissue disease suggests that lipodystrophy is part of a clinical spectrum, rather than a distinct clinical entity. Rheumatology 2001; 40: 1070-1071.

Scleroderma

Primary Atrophic Solitary Morphea Profunda (SMP) is a distinct form of localized scleroderma, mimicking localized lipoatrophy. Our observation highlights the wide spectrum of clinical presentations of localized scleroderma. The latter should be considered in the presence of lipoatrophy-like lesions for proper workup and therapy. Karger Dermatology.

Parry Romberg Syndrome with Involuntary Jaw Closure: An Extremely Rare Association. In lipodystrophy, the involvement is bilateral and spares cartilages and bone; in scleroderma the skin becomes cold, white and inelastic and adherent to the subcutaneous tissue. The skin in PRS remains mobile and grossly normal. JIACM 2006; 7(3): 258-60.

Sclerodermic linear lupus panniculitis: report of two cases. Lupus erythematosus panniculitis is a rare disease characterized by deep subcutaneous nodules, most commonly localized on the upper limbs and face. We present here the clinical characteristics, course and laboratory findings of 2 patients having linear lupus erythematosus panniculitis with localized scleroderma-like changes. PubMed, Dermatology. 2005;210(4):329-32. (Also see Linear Scleroderma, and Overlap Syndrome)

Sjogren's Syndrome

Lipoatrophy can be a common sequela of panniculitis in patients with connective tissue diseases (eg, systemic lupus erythematosus, subcutaneous morphea, the syndrome of lobular lymphocytic connective tissue panniculitis of Winkelmann and Padilha-Goncalves). Lipoatrophy can be associated with nephritis, hypocomplementemia, scleroderma, Sjögren's syndrome, recurrent pyogenic infections, immune thrombocytopenic purpura (ITP), and thyroiditis. Emedicine. (Also see Sjogren's Syndrome)

Thyroiditis

Lipoatrophy can be a common sequela of panniculitis in patients with connective tissue diseases (eg, systemic lupus erythematosus, subcutaneous morphea, the syndrome of lobular lymphocytic connective tissue panniculitis of Winkelmann and Padilha-Goncalves). Lipoatrophy can be associated with nephritis, hypocomplementemia, scleroderma, Sjögren's syndrome, recurrent pyogenic infections, immune thrombocytopenic purpura (ITP), and thyroiditis. Emedicine. (Also see Thyroid Disease)

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