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| Fig. 19.11 A, Acquired partial lipodystrophy with associated C3 nephritic factor. Note the prominent wasting of the facial fat in this patient. B, Localized lipoatrophy associated with injection of medication. (Courtesy of Kenneth E. Greer, MD.) |
Lipodystrophy generally refers to a paucity or complete absence of subcutaneous fat, sometimes due to redistribution. It can be generalized or localized, inherited or acquired. Lipodystrophy can be idiopathic, but is often associated with inherited syndromes, endocrine abnormalities such as insulinresistant diabetes mellitus, complement abnormalities (Fig. 19-11A), or autoimmune disease. It is well recognized that highly active antiretroviral therapy (highly active antiretroviral therapy [HAART], particularly protease inhibitors) causes a distinctive redistribution of subcutaneous fat with accumulation of fat in abdominal and cervical areas and wasting of the face and extremities.
Koutkia P, Grinspoon S: HIV-associated lipodystrophy: pathogenesis, prognosis, treatment, and controversies, Annu Rev Med 55: 303–317, 2004.
