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Lipedematous alopecia

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Lipedematous alopecia
Other namesLipedematous scalp[1]
SpecialtyDermatology

Lipedematous alopecia is a disorder characterized by a thick boggy scalp and hair loss.[1] Symptoms include pain, puritis, headaches, and paresthesia. The cause of lipedematous alopecia is unknown. The diagnosis is made my excluding other disorders, MRI, CT scan, and histopathology. There is no accepted treatment however surgical debunking has been found effective.

Signs and symptoms

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Typically, vertex and occipital regions are where scalp thickening is first observed, and it gradually spreads to the entire scalp.[2] Like a balloon, the lesions can be pushed down to the underlying bone, yet they promptly revert to their original shape. It has been reported that accompanying symptoms include pruritis, discomfort, headaches, and paresthesia.[3]

Causes

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As of right now, there is no solid evidence connecting lipedematous alopecia to other symptoms or genetic abnormalities.[4] Medical issues including skin and joint hyperelasticity, kidney failure, scalp psoriasis, and breast cancer have been recorded in cases of lipedematous alopecia.[5][6] Nevertheless, there is no evidence linking lipedematous alopecia to these illnesses; instead, these conditions appear to be coincidental.[2]

Mechanism

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It has been suggested that leptin, a hormone that controls the distribution of adipose tissue, contributes to subcutaneous fat hyperplasia.[4][7] Adipose tissue displacement and metaplasia are key components of a different explanation of lipedematous alopecia pathophysiology.[8] Hormones may also be involved because women make up the majority of lipedematous alopecia patients; however, there is not enough data to explain why this phenomenon is seen.[4]

Diagnosis

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In order to diagnose lipedematous alopecia, one must evaluate the clinical appearance and rule out illnesses such as cutis verticis gyrata.[8]

A thicker layer of subcutaneous fat with varying disturbance of fatty architecture, the lack of inflammation, normal hair follicles and adnexa, and no apparent lipoma or panniculitis are among the histomorphologic characteristics of lipedematous alopecia.[4] Histopathology, magnetic resonance imaging, and computed tomography scans are examples of diagnostic modalities. Histology typically reveals hyperplasia of the subcutaneous adipose tissue in addition to normal epidermis and dermis.[8]

Treatment

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There is little to no treatment for lipedematous alopecia that can stop or slow progression.[9] There have been unsuccessful attempts at treating the condition with hydroxychloroquine and topical and intralesional steroids.[10][11] After a year, surgical debulking with scalp reduction shows no signs of recurrence, a satisfactory outcome.[7]

See also

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References

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  1. ^ a b Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  2. ^ a b Kilinc, Efsun; Dogan, Sibel; Akinci, Hande; Karaduman, Aysen (2018). "Lipedematous scalp and alopecia: Report of two cases with a brief review of literature". Indian Journal of Dermatology. 63 (4). Medknow: 349–353. doi:10.4103/ijd.ijd_2_17. ISSN 0019-5154. PMC 6052760. PMID 30078883.
  3. ^ Accaputo, Ornella; White, Jonathan Michael; Kolivras, Athanassios; Sadeghi, Niloufar; Berlingin, Evelyne; del Marmol, Véronique (2019-01-23). "Lipedematous Alopecia: Clinical, Histopathological, and Trichoscopic Findings of a Single Case and Review of the Literature". Case Reports in Dermatology. 11 (1): 7–15. doi:10.1159/000496328. ISSN 1662-6567. PMC 11387884.
  4. ^ a b c d Müller, Cornelia S. L.; Niclou, Mylène; Vogt, Thomas; Pföhler, Claudia (2012-01-05). "Lipedematous diseases of the scalp are not separate entities but part of a spectrum of lipomatous lesions". JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 10 (7). Wiley: 501–507. doi:10.1111/j.1610-0387.2011.07830.x. ISSN 1610-0379. PMID 22222012.
  5. ^ Fuentelsaz-del Barrio, V.; Parra-Blanco, V.; Borregón-Nofuentes, P.; Suárez-Fernández, R. (2012). "Alopecia lipedematosa concomitante con psoriasis del cuero cabelludo". Actas Dermo-Sifiliográficas (in Spanish). 103 (6). Elsevier BV: 551–554. doi:10.1016/j.ad.2011.10.012. ISSN 0001-7310. PMID 22465259.
  6. ^ Bridges, A G; von Kuster, L C; Estes, S A (April 2000). "Lipedematous alopecia". Cutis. 65 (4): 199–202. PMID 10795078.
  7. ^ a b Yip, Leona; Mason, Graham; Pohl, Miklos; Sinclair, Rodney (2008). "Successful surgical management of lipoedematous alopecia". Australasian Journal of Dermatology. 49 (1). Wiley: 52–54. doi:10.1111/j.1440-0960.2007.00427.x. ISSN 0004-8380. PMID 18186851.
  8. ^ a b c Chen, Edward; Patel, Raj; Pavlidakey, Peter; Huang, Conway C. (2019). "Presentation, diagnosis, and management options of lipedematous alopecia". JAAD Case Reports. 5 (1). Elsevier BV: 108–109. doi:10.1016/j.jdcr.2018.10.012. ISSN 2352-5126. PMC 6299142. PMID 30581948.
  9. ^ Dhurat, Rachita S.; Daruwalla, Sanober Burzin; Ghate, Smita Sunil; Jage, Mithali Mahendra; Sharma, Aseem (2019). "Distinguishing Lipedematous Scalp, Lipedematous Alopecia, and Diffuse Alopecia Areata". Skin Appendage Disorders. 5 (5): 316–319. doi:10.1159/000495947. ISSN 2296-9195. PMC 6751453. PMID 31559257.
  10. ^ Kavak, Ayşe; Yuceer, Deniz; Yildirim, Ümran; Baykal, Can; Sarisoy, Hasan Tahsin (2008). "Lipedematous scalp: A rare entity". The Journal of Dermatology. 35 (2): 102–105. doi:10.1111/j.1346-8138.2008.00423.x. ISSN 0385-2407. PMID 18271806.
  11. ^ High, Whitney A.; Hoang, Mai P. (2005). "Lipedematous alopecia: An unusual sequela of discoid lupus, or other co-conspirators at work?". Journal of the American Academy of Dermatology. 53 (2). Elsevier BV: S157 – S161. doi:10.1016/j.jaad.2005.01.119. ISSN 0190-9622. PMID 16021169.

Further reading

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  • Yasar, Sirin; Gunes, Pembegul; Serdar, Zehra Asiran; Tosun, Ilkay (2011). "Clinical and pathological features of 31 cases of lipedematous scalp and lipedematous alopecia". European Journal of Dermatology. 21 (4). John Libbey Eurotext: 520–528. doi:10.1684/ejd.2011.1385. ISSN 1167-1122. PMID 21659073.
  • Cabrera, R; Larrondo, J; Whittle, C; Castro, A; Gosch, M (2015). "Successful Treatment of Lipedematous Alopecia using Mycophenolate Mofetil". Acta Dermato Venereologica. 95 (8). Medical Journals Sweden AB: 1011–1012. doi:10.2340/00015555-2114. ISSN 0001-5555. PMID 25881615.
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