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Localized involutional lipoatrophy: a clinicopathologic study of 16 patients

P R Dahl1, M J Zalla, R K Winkelmann

  • 1Department of Dermatology, Mayo Clinic, Rochester, USA.

Journal of the American Academy of Dermatology
|October 1, 1996
PubMed
Summary

Idiopathic lipoatrophy, a localized fat loss, often follows injections and presents with unique microscopic changes. Macrophage infiltration and involuted fat lobules characterize this condition.

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Area of Science:

  • Dermatopathology
  • Adipose Tissue Biology

Background:

  • Idiopathic lipoatrophy is defined as localized adipose tissue loss without prior inflammation.
  • This condition can occur after injections in the affected areas.

Purpose of the Study:

  • To investigate the clinical and pathological characteristics of focal lipoatrophy.
  • To analyze a distinct pathological pattern of fat lobule involution in affected patients.

Main Methods:

  • Retrospective analysis of 16 patients with focal lipoatrophy.
  • Histopathological examination including immunoperoxidase staining and electron microscopy.

Main Results:

  • Most common sites were buttocks and proximal extremities; lesions were solitary or multiple.

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  • Histology revealed decreased adipocyte size, hyaline material, and diminutive fat lobules resembling embryonic fat.
  • Macrophage infiltration (CD68 positive) was observed, with some becoming lipophages.

    • Conclusions:

    • Involutional lipoatrophy is a common post-injury response in fat tissue.
    • Macrophage infiltration of fat lobules is a key feature.
    • The pathological changes justify the term involutional lipoatrophy due to resemblance to embryonic fat lobules.