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Localized Lipodystrophy Clinical Presentation

  • Author: Serhat Aytug, MD; Chief Editor: George T Griffing, MD  more...
Updated: Dec 16, 2014


Localized lipodystrophy usually presents as isolated or multiple, atrophic, depressed areas with induration and indentations typically found in the extremities and other parts of the body in early childhood. These lesions may expand and, sometimes, spontaneously disappear. Lesions usually have no overlying skin changes and might have secondary skin pigmentations. Patients generally do not have any underlying diseases or associated symptoms at the time of presentation.



Localized lipodystrophy typically presents as depressions of the skin in various areas; lesions are multifocal, well-demarcated, and atrophic.

  • Lesions can be pigmented or nonpigmented, and they usually are painless.
  • Lesions can be as big as 15 cm in diameter.
  • Lesions tend to be located proximally, ie, buttocks, thighs, and upper arms are involved more frequently than lower legs are. The face, scalp, breasts, distal aspects of the extremities, and mucous membranes tend to be spared.

Some patients have local panatrophy involving muscle, fat, and morphealike changes.

  • Local panatrophy can present as panatrophy that includes the manifestation of hemifacial atrophy.
  • One subset group has annular atrophy of the ankles and semicircular lipoatrophy of the anterolateral region of the thighs. These signs can be observed in subcutaneous and intradermal injection sites.


The cause of lipodystrophic syndromes is unknown. One subset of the lipodystrophic syndromes is associated with subcutaneous and intradermal injection sites. In this group, trauma may induce the release of macrophage cytokines (eg, tumor necrosis factor, interleukin-1) that might enhance lipocyte catabolism. Impure animal insulin might lead to localized lipodystrophy, possibly because of a cross-reaction with lipid tissues and insulin antibody. Localized lipodystrophy caused by a cross-reaction is very rare with synthetic insulin.[9]

Contributor Information and Disclosures

Serhat Aytug, MD Endocrinologist, Division of Endocrinology, Diabetes and Metabolism, St Jude Heritage Medical Group

Serhat Aytug, MD is a member of the following medical societies: American Association of Clinical Endocrinologists, Endocrine Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Arthur B Chausmer, MD, PhD, FACP, FACE, FACN, CNS Professor of Medicine (Endocrinology, Adj), Johns Hopkins School of Medicine; Affiliate Research Professor, Bioinformatics and Computational Biology Program, School of Computational Sciences, George Mason University; Principal, C/A Informatics, LLC

Arthur B Chausmer, MD, PhD, FACP, FACE, FACN, CNS is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Nutrition, American Society for Bone and Mineral Research, International Society for Clinical Densitometry, American College of Endocrinology, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Medical Informatics Association, Endocrine Society

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD Professor Emeritus of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, International Society for Clinical Densitometry, Southern Society for Clinical Investigation, American College of Medical Practice Executives, American Association for Physician Leadership, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society

Disclosure: Nothing to disclose.

Additional Contributors

David M Klachko, MD, MEd Professor Emeritus, Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of Missouri-Columbia School of Medicine

David M Klachko, MD, MEd is a member of the following medical societies: Alpha Omega Alpha, Missouri State Medical Association, American College of Physicians-American Society of Internal Medicine, American Diabetes Association, American Federation for Medical Research, Endocrine Society, Sigma Xi

Disclosure: Nothing to disclose.


Rubens Sievert, MD Clinical Assistant Professor, Department of Internal Medicine, Mount Sinai School of Medicine

Rubens Sievert, MD is a member of the following medical societies: American Thyroid Association

Disclosure: Nothing to disclose.

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