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Figure 1. Examples of acanthosis nigricans (A & B) in the axilla and (C) on the nape of the neck. Photographs reproduced with the permission of the patients.
(Figure omitted. See article PDF.)
Figure 2. Female patient with acquired generalized lipodystrophy (A & B); note the absence of acanthosis nigricans (C). This patient has pancreatic beta cell failure and a low insulin concentration secondary to recurrent hypertriglyceridemia induced pancreatitis. Photographs reproduced with the permission of the patient.
(Figure omitted. See article PDF.)
Figure 3. Female patients with different subtypes of familial partial lipodystrophy. Shows the typical phenotypes of (A) familial partial lipodystrophy (FPLD) type 1, genetic cause unknown, (B) FPLD type 2, secondary to a mutation in LMNA and (C) FPLD type 3, secondary to a mutation in PPARG . All three patients have axillary acanthosis nigricans as shown in the bottom panel. Photographs reproduced with the permission of the patients.
(Figure omitted. See article PDF.)
Figure 4. Dual-energy x-ray absorptiometry scan: body fat distribution in a patient with familial partial lipodystrophy type 1 (A) pre and (B) 4 months post Roux en-Y gastric bypass surgery. Note marked reduction of abdominal fat post surgery.
(Figure omitted. See article PDF.)
Lipodystrophy is a rare group of conditions characterized by partial or complete loss of subcutaneous adipose tissue. Although a minority of patients with lipodystrophy first present in infancy, the majority present in many other clinical settings. The aim of this review is to enable practicing clinicians in the diabetes, lipid, hepatology, dermatology and gynecology clinics, or in general practice, to recognize that a patient may have lipodystrophy, and to better understand the current clinical management options for these patients. The review will focus on the management of the metabolic sequelae in adult patients, but it is important to note that many of these patients present in childhood or adolescence and that the support needed by these patients goes beyond the problems caused by abnormal metabolism due to the cosmetic, psychological and reproductive implications of these rare conditions.
What is lipodystrophy?
Lipodystrophy is a rare group of conditions characterized by partial or complete loss of subcutaneous adipose tissue. The underlying cause may be genetic or acquired. Lipodystrophy is commonly but not always associated with metabolic derangements...