Lipoatrophia semicircularis: a case report

Abstract

Introduction: Lipoatrophia semicircularis is a rare form of lipodystrophy localized in the thighs, forming a horizontal, symmetrical, and bilateral band. Although its pathogenesis is unknown there are some hypotheses described in the literature, namely: repeated microtrauma, electromagnetic lipolysis, a congenital defect of the lateral circumflex femoral artery, and factors related to climatic conditions inside buildings. We describe a case of semicircular lipoatrophy in a 21-year-old woman.

Case description: A 21-year-old woman, working as a cashier in a pet shop, with no significant previous history and no usual medication. The patient was referred to open consultation for depression on the anterior face of the thighs, with approximately three weeks of evolution. No history of injections at the site of the depression. With the sensation of tired legs. No other associated symptoms. Presented depression on the thighs, bilateral and symmetrical, in a horizontal band. The diagnosis of semicircular lipoatrophy was assumed, the benignity of the situation was explained, and she was advised to avoid trauma to the thigh region. Reassessed after four months, she had undergone the recommended alterations and no longer presented alterations of lipodystrophy.

Comment: Lipoatrophia semicircularis is a benign condition whose diagnosis is clinical, with some authors complementing the diagnosis with ultrasound. Treatment involves the avoidance of the initial trigger, when found and adaptations can be made to the workplace. In Portugal, there are no cases reported in the main databases. This fact may reveal that it is an infrequent pathology or reveal little concern on the part of patients with this alteration, or misdiagnosis. For these reasons, even though it is an innocuous condition, the doctor needs to be aware of its existence for a more effective diagnosis and, consequently, better advice and reassurance for the patient.