The Author

Joachim Zuther, Lymphedema Specialist. Read more
Solaris
MediUSA

Tactile Ad

Differences between Lipedema and Lymphedema

 

As outlined in a  previous entry, lipedema is a chronically progressive, symmetrical accumulation of fat in the subcutaneous tissue occurring almost exclusively in women. Primarily the lower extremities are affected, but lipedema may occur in combination with the upper extremities as well. Lipedema is characterized by symmetric enlargement of the limbs, combined with tenderness and easy bruising.

Lipedema is not caused by a disorder of the lymphatic system; however, it is commonly misdiagnosed as bilateral primary lymphedema.

Several marked differences between lipedema and primary lymphedema can be distinguished; these differences are highlighted in the table below.

Lipedema

While lipedema always affects both legs symmetrically (bilateral appearance), primary lymphedema usually affects one leg only. If both legs are involved in primary lymphedema the swelling appears asymmetric (see image on bottom of this article). The feet are not involved in lipedema; the symmetrical distribution of fat is located between the hips and the ankles.
In contrast, the feet in lymphedema are involved in the swelling, and a diagnostic indicator known as the Stemmer sign is positive.
The Stemmer sign is a diagnostic test that involves pinching the skin on the upper surface of the toe (usually second toe) or fingers. If a fold of skin can be pinched and lifted up at the base of the second toe or middle finger, the Stemmer sign is negative. The Stemmer sign is positive and indicative of lymphedema when a skin fold cannot be lifted, but can only be grasped as a lump of tissue. This sign  will become positive if lipedema develops into lipo-lymphedema. Circumstances that can lead to lipedema developing into lymphedema are explained in a previous post.
Tissue in lipedema has a soft rubber-like feel in early stages and may include small fatty lumps (nodules) within the tissues in

Fatty nodules in lipedema

later stages. Pressure with the thumb does not leave an indentation (no pitting) in lipedema. Lymphedema is pitting and the tissue feels firmer that the one in lipedema, especially with fibrotic tissue typically being present starting in stage 2. The cause for the onset of lymphedema are malformations of the lymphatic system, while he underlying cause for the development of lipedema remains unknown; it is thought to be associated with hormonal disorders.

 

 

Differences at a Glance

 

Lipedema Lymphedema
Symmetric (buttocks involved) Not symmetric
Foot not involved Foot involved
Not pitting Pitting edema
Stemmer sign negative Stemmer sign positive
Tissue feels rubbery Tissue feels firmer (starting stage 2 lymphedema)
Painful to touch Generally not painful to touch
Easy bruising Generally not bruising
Hormonal disturbances frequent Generally no hormonal disturbance

Stemmer sign; positive on left

 

Primary bilateral lymphedema

 Join Lymphedema Guru, a Facebook page solely dedicated to inform about all things related to lymphedema – news, support groups, treatment centers, and much more

Additional Reading:

http://www.hanse-klinik.com/englisch/Lipoedema.pdf

http://www.lymphedemapeople.com/wiki/doku.php?id=lipedema

http://www.lymphedema-therapy.com/Lipedema.htm

 

 

7 comments to Differences between Lipedema and Lymphedema

  • Pat

    Another great page of info. Thanks!!!! To treat correctly it is critical to understand the two conditions, how they are and/or are not related. It is also terribly important for those with lipedema to understand this is NOT a weight issue in the sense that you can NOT diet your way out of lipedema. The Lymphedema Blog is definitely on my list of favorite sites both in terms of topics, your willingness to reach out to patients and then in the use of evidence based medicine.

  • Mary Beth

    There is also an extremely rare condition called Dercum’s Disease which presents with extremely painful fatty nodules and can include swelling. Some of these patients have been misdiagnosed as lipedema or lipolymphedema. I have treated one patient with it who found relief with MLD (although initially with nausea) and has found even greater relief with daily use of Flexitouch.

  • Is there any cure or treatment for lypedema?

  • Joey Beth

    I have Lymphedema and my left leg is extremely sensitive…if I barely bump it the pain is excruciating.

  • debbie west

    I KNOW it is Hormonally related. When I was 32 years old, I had to have hysterctomy for endometriosis. After they took everything, I noticed that I started distributing fat in a different way! I was about 130lbs, and 5’7” …..but I noticed on my thighs, I was starting to get little round globulas underneath the skin of small circles of fat. It seemed as though it was no longer being evenly distributed. I tried to tell my Dr’s but just didn’t know, or didn’t take the time to figure it out, or thought I was over`reating. Now I am a few years away from 60. I developed Lymphedema in my right arm, no breast surgery. The round areas of fat have gotten much worse. I am on NO hormone replacement for 6 years now because I have had 3 PE’s (blood clots in the lungs)….so they will give me no hormones. I’m telling you, it’s time for the Medical World to wake up and realize that Hormones do a LOT more for us than what we know, or have studied!! Since I have been without hormones, I am getting facial changes. That feminine look is going away, I’m getting chin hair, you know the whole bunch of changes. I believe that women aged and died younger years ago, due to loss of hormones partly. Then they had to figure out what kind and how much to replace. This has a BIG difference in the aging process, I am convinced!! I need to find a natural replacement that will at least help restore something, though I fear it may already be too late. Did I mention it is almost near impossible to loose weight? Don’t eat, you don’t loose. Eat a little you balloon up….!!! Arrrggggg!!!!!

  • Pamela Hain

    I have edema in both legs and both hands.I believe it is lymphedema. The therapist says that it is not possible to have lymphedema in all four extremities. She also says lymphedema does not cause pain. I had breast cancer surgery 7 years ago and 27 lymph nodes were removed and was followed by radiation.

  • Regina

    Has anyone with Lympoedema and lipedema ever received disability benefits either from work or the state that they live in. Are they starting to take it as a serious disease. Any help in this area would be greatly appreciated,

Leave a Reply

 

 

 

You can use these HTML tags

<a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>