Abstract

SANTILLAN-AGUAYO, Enrique. Lipedema: a revision and new lines of investigation in the comprehensive vascular field. Rev. mex. angiol. [online]. 2025, vol.53, n.2, pp.72-80.  Epub Aug 29, 2025. ISSN 2696-130X.  https://doi.org/10.24875/rma.23000040.

Lipedema is a disease that involves multiple biomechanical changes and, therefore, vascular, musculoskeletal, skin, and nerve changes, requiring comprehensive and multidisciplinary treatment. This entity should be completely removed from the concepts applied by plastic surgery, as the action subsumes the concept to a cosmetic problem that requires or not cosmetic intervention, preventing the comprehensive benefit required by this group of patients. The most frequent musculoskeletal alterations include the pronation of the footstep due to the pronation position of the ankle, with or without the presence of a flat arch, hallux valgus, or indirect findings such as linear hyperkeratosis on the medial transition edge of the first toe, even medial rotation of the distal phalanx of the first toe. It is also accompanied by valgus in the knees, pelvic dysmetria, and spondyloarthropathy. Vascular alterations include venous disease and lymphedema, skin predisposition to dermatopathies as well as the appearance of spontaneous bruising or mild traumas, and nerve changes such as secondary neuropathies. Finally, it is essential to study the association of lipedema with nervous dysautonomia, since a large percentage of patients tend to have hypotension, the presence of orthostatic intolerance, thermoregulatory alterations, and even symptoms associated with vesicular dyskinesia.

Keywords : Lipedema; Lipoedema; Venous disease; Lymphatic disease.

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