Background & Aims

Lipohyperplasia dolorosa (LiDo, also known as lipedema, is a bilateral subcutaneous adipose tissue disorder affecting mostly women characterized by an amassing of adipocytes in the extremities sparing hands and feet(1). Objective measurement-based diagnosis is currently missing. Pain specifically in affected body parts is a LiDo-defining characteristic. While the accumulating adipose tissue has attracted much attention, a differentiating characterization of LiDo-pain has not been attempted. An objectifiable and comprehensive characterization of the sensory profile including pain of LiDo patients is currently missing.

Methods

20 non-obese LiDo patients and 20 age- and waist-to-height-ratio matched controls were measured at thigh and dorsum of the hand using the clinically approved QST protocol of the German Research Association on Neuropathic Pain (DFNS e.V.). Further, pain and psychometry of participants were assessed using the German Pain Questionnaire.

Results

LiDo patients showed no overt psychometric abnormalities and pain was preferentially described in somatic terms. All QST-measurements were normal with the specific exception of two. Specifically at the affected thigh, the pressure pain threshold (PPT) was strongly reduced and the vibration detection threshold (VDT) strongly increased in LiDo-patients. In contrast, sensory profiles at the dorsum of the hand were normal. ROC-analysis of PPT and VDT of thigh versus hand, combined in a PVTH-score (Pressure, Vibration, Thigh, Hand) shows very high sensitivity and specificity categorizing correctly 96.5% of the measured participants as LiDo patients or healthy controls. Bayesian inference confirmed the diagnostic potential of a combined PVTH-score.

Conclusions

LiDo pain in lean patients appears as somatic rather than neuropathic or psychosomatic. We saw distinct alteration of PPT and VDT specifically only at the affected thigh but not the hand suggests a fast and easy-to-use test for the identification of lean LiDo patients.

References

Lipedema pain-the neglected symptom. Hucho, T, Dermatologie, 2023.

Presenting Author

Tim Hucho

Poster Authors

Tim Hucho

PhD

University Hospital Cologne

Lead Author

E-mail

Rebecca Dinnendahl

MSc

University Hospital Cologne

Lead Author

E-mail

Dominik Tschimmel

MSc

University Hospital Cologne

Lead Author

E-mail

Manuel Cornely

LY.SEARCH GmbH

Lead Author

E-mail

Topics

  • Pain in Special Populations: Adolescents