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Skin lipoma: causes, symptoms, diagnosis, treatment
Last reviewed: 05.07.2025
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[ Causes of skin lipoma
It occurs at any age, more often in women, and can reach significant sizes. Multiple lipomatosis has three varieties: Dercum's disease (lipomatosis dolorosa), benign symmetrical lipomatosis (Madelung's disease) and familial multiple lipomatosis, inherited in an autosomal dominant manner, appearing at a young age.
Pathomorphology
Microscopically, the tumor is built like normal adipose tissue and differs from it in the size of the lobules and fat cells. The latter can be very small or reach gigantic sizes. In some cases, there is a proliferation of connective tissue between the lobules and individual fat cells, sometimes significant, forming a fibrolipoma. If it contains a large number of vessels, the tumor is called angiolipoma.
In Dercum's disease, the histological picture is often similar to that described above, but in some cases an angiolipoma structure or granulomatous structure with the presence of giant foreign body cells is observed.
In benign symmetrical lipomatosis and familial multiple multicentric lipomatosis, the nodes have the structure of a normal lipoma. In the systemic form of multiple lipomatosis, in addition to mature fat cells, undifferentiated mesenchymal and intermediate cells are found, containing varying amounts of lipids in their cytoplasm. In well-differentiated areas, mature fat cells are visible, usually located in the mucoid stroma; in less differentiated zones, there are lipoblasts of varying degrees of maturity containing lipids, as well as areas consisting of fibroblastic elements.
Symptoms of skin lipoma
Lipoma is a benign tumor of adipose tissue, manifested by single or multiple subcutaneous nodes, round or lobular, of a soft-elastic consistency, usually not fused with the skin.
In multiple symmetrical lipomatosis, the lesions are large, merging with each other, of elastic consistency, and are most often localized on the neck, in the occipital region, upper body, and proximal parts of the extremities.
Single or multiple lipomas are usually located on the abdomen, back, and limbs. They are soft to the touch, painless, mobile, the color of normal skin, and from 1 cm to 10 cm in diameter.
There are several types of lipomatosis.
Multiple symmetrical lipomatosis (Madelung syndrome) occurs in middle-aged men. The rash consists of painless lipomas that merge with each other. They appear on the trunk, neck, and sometimes on the extremities. When lipomas merge, a kind of "collar" is formed around the neck.
Multiple painful lipomas that appear on the trunk and limbs are called Dercum's disease (painful lipomatosis).
Lipomatosis sometimes runs in families with an autosomal dominant inheritance pattern.
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Treatment of skin lipoma
Single and multiple lipomas are removed before they reach a large size.