Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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September 13, 2018
Lipedematous scalp
- Background
- Lipedematous scalp (LS) is a rare condition of unknown origin resulting from subcutaneous tissue hyperplasia. It occurs at any age, but women are predominantly affected.
- Clinical Presentation
- Scalp thickening may be asymptomatic, but some patients complain of pruritus, pain, or dysesthesia. The vertex and the occipital scalp are the most commonly affected areas.
- Key Diagnostic Features
- The CT scan shows diffuse thickening of the scalp without focal lesions or involvement of any osseous or cerebral structures.
- Pathologic thickness is reported to be more than 9 millimeters.
- Histopathologically, the condition is characterized by increased subcutaneous tissue thickness with proliferation of mature adipose cells without inflammation or hair abnormalities.
- Differential Diagnosis
- The main differential diagnosis is cutis verticis gyrata, a scalp thickening with skin folds and convolutions (cerebriform aspect). It can be idiopathic, a congenital disorder; or it can be associated with leukemia, acromegaly, or myxedema. Additional differential diagnoses are subcutaneous neoplasms, panniculitis, subcutaneous granuloma annulare, or chronic infection.
- Treatment
- To date, there have not been any reports on the treatment of LS.
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