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What is Lipedema and explain in detail?
Lipedema is a condition that is almost exclusively found in women and results in enlargement of both legs due to deposits of fat under the skin. Women of any weight may develop lipedema and the fat associated with lipedema is resistant to traditional weight-loss methods. There is no cure and typically it gets worse over time, pain may be present, and patients bruise easily. Over time mobility may be reduced, and due to reduced quality of life, patients often experience depression. In severe cases the trunk and upper body may be involved. Lipedema is commonly misdiagnosed and is now becoming known as lipoalgia due to there being no oedema.The cause is unknown but is believed to involve genetics and hormonal factors. It often runs in families; having a family member with the condition is a risk factor for developing it. Other conditions that may present similarly include lipohypertrophy, chronic venous insufficiency, and lymphedema. It is estimated to affect up to 11% of women. Onset is typically during puberty, pregnancy, or menopause.The fat associated with lipedema is shown to be resistant to weight loss methods; however, unlike other fat, lipedema is not associated with increased risks of diabetes or cardiovascular disease. Physiotherapy may help to preserve mobility for a little longer than would otherwise be the case. Exercise, only as much as the patient is able to do without causing damage to the joints, may help with overall fitness but will not prevent progression of the disease. Compression stockings can help with pain and make walking easier. Regularly moisturising with emollients protects the skin and prevents it from drying out. Liposuction to remove the fat can help if the symptoms are particularly severe. While surgery can remove fat tissue it can also damage lymphatic vessels. Treatment does not typically result in complete resolution.

Presentation
Associated conditions
Depression and anxiety are very common for a variety of reasons, particularly the fact that diagnosis usually takes a long time and patients have received much advice on diet and exercise in the meantime, neither of which are effective treatment for the lipedema although they may help associated conditions. Joint pain, arthritis, dry skin, fungal infections, cellulitis and slow wound healing are also associated with lipedema.

Diagnosis
Differential diagnosis
Lipedema stages
Lipedema is classified by stage:
Stage 1: Normal skin surface with enlarged hypodermis (lipedema fat).
Stage 2: Uneven skin with indentations in fat and larger hypodermal masses (lipomas).
Stage 3: Bulky extrusions of skin and fat cause large deformations especially on the thighs and around the knees. These large extrusions of tissue drastically inhibit mobility.

Similar conditions
Lipedema is often underdiagnosed due to the difficulty in differentiating it from lymphedema, obesity, or other edemas.

Lipo-lymphedema
Lipo-lymphedema, a secondary lymphedema, is associated with both lipedema and obesity (which occur together in the majority of cases), most often lipedema stages 2 and 3.

Dercums disease
Lipedema / Dercums disease differentiation – these conditions may co-exist. Dercums disease is a syndrome of painful growths in subcutaneous fat. Unlike lipedema, which occurs primarily in the trunk and legs, the fatty growths can occur anywhere on the body.

Treatment
A number of treatments may be useful including physiotherapy and light exercise which does not put undue stress on the lymphatic system