Lipoatrophy as a manifestation of different clinical scenarios: corticosteroid injection, lupus profundus and morphea induced lipoatrophy.

Abstract

Background: Lipoatrophy(Lipodystrophy) is a defect of lipid metabolism resulting in adipose tissue atrophy or altered fat deposition. Lipodystrophies are categorized into congenital or acquired and generalized or localized. The localized lipodystrophies can be classified into drug induced, pressure induced, panniculitis associated, or idiopathic in origin.   Objective: To report the frequency of different types of acquired dermolipoatrophy in relation to different etiological factors. Patients and methods: In this observational case series descriptive study, twenty nine patients with different clinical forms of acquired lipoatrophy were enrolled during the period from 2006-2020.  For every patient, a full history and complete systemic and cutaneous examination were performed.  Laboratory investigations were done, when it is needed. Results: Twenty nine patients with localized lipoatrophy, 16 (55.2%) females ,13 (44.8%) males ,with  ages ranged from 3-55 years (mean 16.7 years) were evaluated and analyzed. The current work showed that intralesional and intramuscular triamcinolone injection was the most frequent cause responsible for development of localized lipoatrophy in 27(93.1%) patients followed by morphea and lupus profundus in only 1 (3.45%) patient for each .With regard to corticosteroid induced lipoatrophy, the buttock was the most commonly affected site in 14 (51.9%) patients and all the affected patients were children while the scalp was involved in 12 (44.4%) patients and forearm in 1 (3.7%) patient. Conclusion: Lipoatrophy following intramuscular and intralesional corticosteroid preparation particularly triamcinolone acetonide is an important and common cause for acquired lipoatrophy with significant psychological sequelae for the affected patients and / or their parents. Also lupus profundus and linear morphea are  important diseases to be considered while evaluating patients with acquired lipoatrophy.