Localized Lipodystrophy Treatment & Management
- Author: Serhat Aytug, MD; Chief Editor: George T Griffing, MD more...
No specific medical treatment exists.
Treatment of insulin lipodystrophy consists of reassuring the patient that the condition is benign, switching to purified insulin (pork or human), and having the patient inject insulin in noninvolved areas and rotate the injection sites. This regimen is effective in more than 95% of patients. Improvement begins in 2-4 weeks, and normal consistency generally is restored within 2 months.
Treatment of underlying immunological disorders might prevent progression of the disease.
Surgical treatment with adipofascial flaps has been successful in some cases.
Dermatological, medical, and surgical consultations are appropriate.
No specific dietary recommendations or restriction of diet has been recommended.
No specific activity or restriction of activity has been proposed.
Garg A. Lipodystrophies: genetic and acquired body fat disorders. J Clin Endocrinol Metab. 2011 Nov. 96(11):3313-25. [Medline].
Touraine P, D'Souza GA, Kourides I, et al. Lipoatrophy in GH deficient patients treated with a long-acting pegylated GH. Eur J Endocrinol. 2009 Oct. 161(4):533-40. [Medline].
Winkelmann RK, Padilha-Goncalves A. Connective tissue panniculitis. Arch Dermatol. 1980 Mar. 116(3):291-4. [Medline].
Gdynia HJ, Weydt P, Ernst A, et al. Myositis associated with localized lipodystrophy: an unrecognized condition?. Eur J Med Res. 2009 May 14. 14(5):228-30. [Medline].
Nolis T. Exploring the pathophysiology behind the more common genetic and acquired lipodystrophies. J Hum Genet. 2014 Jan. 59(1):16-23. [Medline].
Hisamichi K, Suga Y, Hashimoto Y, Matsuba S, Mizoguchi M, Ogawa H. Two Japanese cases of localized involutional lipoatrophy. Int J Dermatol. 2002 Mar. 41(3):176-7. [Medline].
Yamamoto T, Yokozeki H, Nishioka K. Localized involutional lipoatrophy: report of six cases. J Dermatol. 2002 Oct. 29(10):638-43. [Medline].
Soos N, Shakery K, Mrowietz U. Localized panniculitis and subsequent lipoatrophy with subcutaneous glatiramer acetate (Copaxone) injection for the treatment of multiple sclerosis. Am J Clin Dermatol. 2004. 5(5):357-9. [Medline].
Peteiro-Gonzalez D, Fernandez-Rodriguez B, Cabezas-Agricola JM, Araujo-Vilar D. Severe localized lipoatrophy related to therapy with insulin analogs in type 1a diabetes mellitus. Diabetes Res Clin Pract. 2011 Mar. 91(3):e61-3. [Medline].
Winkelmann RK, Frigas E. Eosinophilic panniculitis: a clinicopathologic study. J Cutan Pathol. 1986 Feb. 13(1):1-12. [Medline].
Winkelmann RK. [Panniculitis with cellular phagocytosis. Chronic form of histiocytic panniculitis with fever, pancytopenia, polyserositis and lethal hemorrhagic diathesis]. Hautarzt. 1980 Nov. 31(11):588-94. [Medline].
Gassling VL, Douglas T, Wiltfang J, et al. Unilateral atrophy of the cheek: autologous fat injection as treatment of choice. J Craniofac Surg. 2009 Mar. 20(2):423-5. [Medline].
Buyukgebiz A, Aydin A, Dundar B, Yorukoglu K. Localized lipoatrophy due to recombinant growth hormone therapy in a child with 6.7 kilobase gene deletion isolated growth hormone deficiency. J Pediatr Endocrinol Metab. 1999 Jan-Feb. 12(1):95-7. [Medline].
Capanni C, Mattioli E, Columbaro M, Lucarelli E, Parnaik VK, Novelli G, et al. Altered pre-lamin A processing is a common mechanism leading to lipodystrophy. Hum Mol Genet. 2005 Jun 1. 14(11):1489-502. [Medline].
Drago F, Rongioletti F, Battifoglio ML, Rebora A. Localised lipoatrophy after acupuncture. Lancet. 1996 May 25. 347(9013):1484. [Medline].
Koshy CE, Evans J. Facial contour reconstruction in localised lipodystrophy using free radial forearm adipofascial flaps. Br J Plast Surg. 1998 Oct. 51(7):499-502. [Medline].
Peters MS, Winkelmann RK. Localized lipoatrophy (atrophic connective tissue disease panniculitis). Arch Dermatol. 1980 Dec. 116(12):1363-8. [Medline].
Peters MS, Winkelmann RK. The histopathology of localized lipoatrophy. Br J Dermatol. 1986 Jan. 114(1):27-36. [Medline].
Serrao VV, Feio AB. Localized abdominal idiopathic lipodystrophy. Dermatol Online J. 2008 Jul 15. 14(7):15. [Medline].