clinical features

Last reviewed 01/2018

• characterized by bilateral, symmetric lower extremity enlargement due to subcutaneous deposition of fat

  • involvement typically extends from the buttocks to the ankles; the feet are much less involved or spared entirely
  • affects women almost exclusively, typically developing insidiously after puberty and progressing gradually

   

• Summary features include:

• Gender	Women almost exclusively
  Age at onset	Often around puberty
  Distribution	Bilateral lower extremities, symmetric involvement
  Epidermal change	Absent
  Foot involvement	Absent, negative Stemmer's sign
  Buttock involvement	Present
  Nature of swelling	Soft, minimally pitting
  Tenderness	Common with pressure
  Easy bruising of affected area	Present
  Improvement with elevation and compression	Minimal
  Family history	Frequent
  History of cellulitis, lymphangitis, and venous disease	Uncommon

Stemmer's sign is positive in lymphoedema but negative in lipoedema

• a positive Stemmer's sign is a skin fold at the base of the second toe too thick to lift