What’s lipohypertrophy?

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Lipohypertrophy is a skin condition where abnormal fatty deposits develop under the skin, caused by endocrine disorders, repeated injections, or certain medications. Treatment involves eliminating the cause or cosmetic correction. Liposuction or dermal fillers can be used for cosmetic purposes.

Individuals with lipohypertrophy generally have abnormal fatty deposits, or fat, under the skin. Certain endocrine disorders can cause the affliction, and repeated subcutaneous injections can also precipitate it. The condition can also occur after extensive use of certain antidiabetic or antiviral drugs. Treatment may involve eliminating the causative factors, but the abnormality may also be corrected cosmetically.

Lipohypertrophy belongs to a group of skin conditions known as lipodystrophy, which is an abnormal distribution of fatty tissue. Depending on the cause, the deposits can develop as a small lump under the skin. However, larger accumulations of fatty tissue may occur in other patients.

Individuals with endocrine disorders commonly experience this condition. When the adrenal glands release too much cortisol, patients develop a condition known as Cushing’s disease in which excess fat and fluid build up in the abdomen, back and face. Pituitary tumors can also affect the adrenal glands and cause the disorder.

Insulin-dependent diabetics commonly experience this form of lipohypertrophy, although patients who receive repeated injections of other medications can develop the same problem. Injections given repeatedly in the same site not only contribute to the formation of scar tissue, but also to the possibility of developing abnormal deposits of fatty tissue. Healthcare professionals suggest that patients minimize or prevent this reaction by switching injection sites frequently. Some studies suggest that patients using synthetic insulins are more prone to developing lipohypertrophy, and in some cases, changing insulin or adjusting dosages has eliminated the problem.

Patients taking antiviral drugs to treat human immunodeficiency virus (HIV) also commonly develop this disorder. These patients may experience a combination of lipohypertrophy symptoms. Not only do they develop excess fat deposits, but they also experience involutional lipoatrophy or abnormal fat loss. Patients with HIV may experience abnormal fat accumulations in the abdomen, back and breasts along with the buildup of extra tissue in the neck and shoulders. Simultaneously, some experience tissue loss in the face, limbs, and buttocks.

Some believe that the HIV virus is responsible for the fat changes, as HIV-positive patients typically have higher blood lipid levels. Others believe the medications contribute to the disorder. Protease inhibitors damage enzymes that normally break down excess fat, and nucleoside reverse transcription inhibitors interfere with cell mitochondria, which can contribute to abnormal body functions. Symptoms can be reversed by changing the treatment regimen.

Regardless of the factors causing the disorder, some affected individuals improve with dietary changes and additional exercise. Some employ cosmetic surgery as a treatment for lipohypertrophy. Cosmetic surgeons commonly use liposuction to remove abnormal fatty tissue. Individuals suffering from tissue loss can opt for dermal fillers.

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