Lipedematous scalp is a rare condition characterized by the accumulation of fatty tissue in the subcutaneous layer of the scalp, resulting in soft enlargement of the head. If it is associated with loss of hair then the term lipedematous alopecia is used.
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Pathology
Histology demonstrates increased thickness of subcutaneous tissue, with proliferation of non-neoplastic normal-appearing mature adipose cells. No evidence of inflammation 2,5.
Radiographic features
The condition is characterized by thickening of the fatty subcutaneous layer of the scalp, over 9 mm but up to several centimeters; the normal thickness of the scalp in adults is ~6 mm measured at the bregma 2. This is visible on CT, ultrasound and MRI, but care should be taken not to mistake rolled up folds of loose scalp or an oblique section through the scalp as actual thickening.
Treatment and prognosis
No treatment is as yet proven and the condition does not usually progress.
History and etymology
The term lipedematous alopecia was first coined in 1961 by Coskey et al. 3, the first case report was described by Cornbleet et al. in 1935 4.
Differential diagnosis
- cutis verticis gyrata
- subcutaneous granuloma annulare
- subcutaneous neoplasms
- chronic infection
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