High‐resolution cutaneous ultrasonography to differentiate lipoedema from lymphoedema
Identifieur interne : 000F45 ( Istex/Corpus ); précédent : 000F44; suivant : 000F46High‐resolution cutaneous ultrasonography to differentiate lipoedema from lymphoedema
Auteurs : M. Naouri ; M. Samimi ; M. Atlan ; E. Perrodeau ; C. Vallin ; G. Zakine ; L. Vaillant ; L. MachetSource :
- British Journal of Dermatology [ 0007-0963 ] ; 2010-08.
Abstract
Background Lipoedema is an accumulation of fat abnormally distributed in the lower limbs, and lymphoedema is oedema caused by a deficiency of the lymphatic system. High‐resolution ultrasound operating at 20 MHz makes it possible to characterize dermal oedema.
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DOI: 10.1111/j.1365-2133.2010.09810.x
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Atlan</name><affiliation><mods:affiliation>Department of Plastic Surgery, CHRU, Tours, France</mods:affiliation></affiliation></author><author><name sortKey="Perrodeau, E" sort="Perrodeau, E" uniqKey="Perrodeau E" first="E." last="Perrodeau">E. Perrodeau</name><affiliation><mods:affiliation>Inserm CIC 202, Tours, France</mods:affiliation></affiliation></author><author><name sortKey="Vallin, C" sort="Vallin, C" uniqKey="Vallin C" first="C." last="Vallin">C. Vallin</name><affiliation><mods:affiliation>Department of Radiology, CHRU, Tours, France</mods:affiliation></affiliation></author><author><name sortKey="Zakine, G" sort="Zakine, G" uniqKey="Zakine G" first="G." last="Zakine">G. Zakine</name><affiliation><mods:affiliation>Department of Plastic Surgery, CHRU, Tours, France</mods:affiliation></affiliation></author><author><name sortKey="Vaillant, L" sort="Vaillant, L" uniqKey="Vaillant L" first="L." last="Vaillant">L. Vaillant</name><affiliation><mods:affiliation>Department of Dermatology, Université François Rabelais, CHRU de Tours, 37044 Tours Cedex 1, France</mods:affiliation></affiliation><affiliation><mods:affiliation>UMR, Inserm U930, CNRS ERL 3106, Tours, France</mods:affiliation></affiliation></author><author><name sortKey="Machet, L" sort="Machet, L" uniqKey="Machet L" first="L." last="Machet">L. 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Naouri</name><affiliation><mods:affiliation>Department of Dermatology, Université François Rabelais, CHRU de Tours, 37044 Tours Cedex 1, France</mods:affiliation></affiliation></author><author><name sortKey="Samimi, M" sort="Samimi, M" uniqKey="Samimi M" first="M." last="Samimi">M. Samimi</name><affiliation><mods:affiliation>Department of Dermatology, Université François Rabelais, CHRU de Tours, 37044 Tours Cedex 1, France</mods:affiliation></affiliation></author><author><name sortKey="Atlan, M" sort="Atlan, M" uniqKey="Atlan M" first="M." last="Atlan">M. Atlan</name><affiliation><mods:affiliation>Department of Plastic Surgery, CHRU, Tours, France</mods:affiliation></affiliation></author><author><name sortKey="Perrodeau, E" sort="Perrodeau, E" uniqKey="Perrodeau E" first="E." last="Perrodeau">E. 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Machet</name><affiliation><mods:affiliation>Department of Dermatology, Université François Rabelais, CHRU de Tours, 37044 Tours Cedex 1, France</mods:affiliation></affiliation><affiliation><mods:affiliation>UMR, Inserm U930, CNRS ERL 3106, Tours, France</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">British Journal of Dermatology</title><title level="j" type="alt">BRITISH JOURNAL OF DERMATOLOGY</title><idno type="ISSN">0007-0963</idno><idno type="eISSN">1365-2133</idno><imprint><biblScope unit="vol">163</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="296">296</biblScope><biblScope unit="page" to="301">301</biblScope><biblScope unit="page-count">6</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2010-08">2010-08</date></imprint><idno type="ISSN">0007-0963</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0007-0963</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Background Lipoedema is an accumulation of fat abnormally distributed in the lower limbs, and lymphoedema is oedema caused by a deficiency of the lymphatic system. High‐resolution ultrasound operating at 20 MHz makes it possible to characterize dermal oedema.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>lymphoedema</json:string><json:string>lipoedema</json:string><json:string>ultrasound</json:string><json:string>dermal</json:string><json:string>dermis</json:string><json:string>oedema</json:string><json:string>hypoechogenicity</json:string><json:string>echogenicity</json:string><json:string>ultrasonography</json:string><json:string>cutaneous</json:string><json:string>dermatologist</json:string><json:string>dermal thickness</json:string><json:string>lower limbs</json:string><json:string>cutaneous ultrasonography</json:string><json:string>dermatol</json:string><json:string>dermatology</json:string><json:string>lymphatic</json:string><json:string>lymphoscintigraphy</json:string><json:string>ultrasound imaging</json:string><json:string>dermatologists british journal</json:string><json:string>british association</json:string><json:string>lower limb</json:string><json:string>authors journal compilation</json:string><json:string>imaging</json:string><json:string>dermal hypoechogenicity</json:string><json:string>lymphatic system</json:string><json:string>dermal oedema</json:string><json:string>dermal echogenicity</json:string><json:string>dermohypodermal junction</json:string><json:string>skin surface</json:string><json:string>upper dermis</json:string><json:string>stemmer sign</json:string><json:string>ultrasound device</json:string><json:string>inclusion criteria</json:string><json:string>clinical diagnosis</json:string><json:string>ultrasound images</json:string><json:string>swollen legs</json:string><json:string>acad dermatol</json:string></teeft></keywords><author><json:item><name>M. Naouri</name><affiliations><json:string>Department of Dermatology, Université François Rabelais, CHRU de Tours, 37044 Tours Cedex 1, France</json:string></affiliations></json:item><json:item><name>M. Samimi</name><affiliations><json:string>Department of Dermatology, Université François Rabelais, CHRU de Tours, 37044 Tours Cedex 1, France</json:string></affiliations></json:item><json:item><name>M. Atlan</name><affiliations><json:string>Department of Plastic Surgery, CHRU, Tours, France</json:string></affiliations></json:item><json:item><name>E. Perrodeau</name><affiliations><json:string>Inserm CIC 202, Tours, France</json:string></affiliations></json:item><json:item><name>C. Vallin</name><affiliations><json:string>Department of Radiology, CHRU, Tours, France</json:string></affiliations></json:item><json:item><name>G. Zakine</name><affiliations><json:string>Department of Plastic Surgery, CHRU, Tours, France</json:string></affiliations></json:item><json:item><name>L. 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Journal Compilation © 2010 British Association of Dermatologists</licence></availability><date type="published" when="2010-08"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">High‐resolution cutaneous ultrasonography to differentiate lipoedema from lymphoedema</title><title level="a" type="short">Differentiating lipoedema from lymphoedema</title><author xml:id="author-0000"><persName><forename type="first">M.</forename><surname>Naouri</surname></persName><affiliation>Department of Dermatology, Université François Rabelais, CHRU de Tours, 37044 Tours Cedex 1, France<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0001"><persName><forename type="first">M.</forename><surname>Samimi</surname></persName><affiliation>Department of Dermatology, Université François Rabelais, CHRU de Tours, 37044 Tours Cedex 1, France<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">M.</forename><surname>Atlan</surname></persName><affiliation>Department of Plastic Surgery, CHRU, Tours, France<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">E.</forename><surname>Perrodeau</surname></persName><affiliation>Inserm CIC 202, Tours, France<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">C.</forename><surname>Vallin</surname></persName><affiliation>Department of Radiology, CHRU, Tours, France<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0005"><persName><forename type="first">G.</forename><surname>Zakine</surname></persName><affiliation>Department of Plastic Surgery, CHRU, Tours, France<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0006"><persName><forename type="first">L.</forename><surname>Vaillant</surname></persName><affiliation>Department of Dermatology, Université François Rabelais, CHRU de Tours, 37044 Tours Cedex 1, France<address><country key="FR"></country></address></affiliation><affiliation>UMR, Inserm U930, CNRS ERL 3106, Tours, France<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0007"><persName><forename type="first">L.</forename><surname>Machet</surname></persName><affiliation>Department of Dermatology, Université François Rabelais, CHRU de Tours, 37044 Tours Cedex 1, France<address><country key="FR"></country></address></affiliation><affiliation>UMR, Inserm U930, CNRS ERL 3106, Tours, France<address><country key="FR"></country></address></affiliation></author><idno type="istex">21411E2E0A31CE465704101B812238CFE24071E3</idno><idno type="DOI">10.1111/j.1365-2133.2010.09810.x</idno><idno type="unit">BJD9810</idno><idno type="toTypesetVersion">file:BJD.BJD9810.pdf</idno></analytic><monogr><title level="j" type="main">British Journal of Dermatology</title><title level="j" type="alt">BRITISH JOURNAL OF DERMATOLOGY</title><idno type="pISSN">0007-0963</idno><idno type="eISSN">1365-2133</idno><idno type="book-DOI">10.1111/(ISSN)1365-2133</idno><idno type="book-part-DOI">10.1111/bjd.2010.163.issue-2</idno><idno type="product">BJD</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">163</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="296">296</biblScope><biblScope unit="page" to="301">301</biblScope><biblScope unit="page-count">6</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2010-08"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><head>Summary</head><p><hi rend="bold">Background </hi> Lipoedema is an accumulation of fat abnormally distributed in the lower limbs, and lymphoedema is oedema caused by a deficiency of the lymphatic system. High‐resolution ultrasound operating at 20 MHz makes it possible to characterize dermal oedema.</p><p><hi rend="bold">Objectives </hi> The purpose of our study was to demonstrate that high‐resolution ultrasound imaging of the skin can differentiate lipoedema from lymphoedema.</p><p><hi rend="bold">Methods </hi> Sixteen patients with lymphoedema (22 legs), eight patients with lipoedema (16 legs) and eight controls (16 legs) were included. Patients with lipolymphoedema were excluded. Ultrasound examinations were carried out with a real‐time high‐resolution ultrasound device on three different sites for each lower limb. The images were then anonymized and examined by an independent dermatologist who was blind to the clinical diagnosis. A new series of images was examined by three dermatologists to check interobserver agreement.</p><p><hi rend="bold">Results </hi> A significant difference in dermal thickness was observed between patients with lymphoedema and those with lipoedema and between patients with lymphoedema and controls. No significant difference in dermal thickness was shown between patients with lipoedema and controls at the thigh or ankle. Dermal hypo‐echogenicity was found in at least one of the three sites in 100% of patients with lymphoedema, 12·5% of cases with lipoedema and 6·25% of the controls. Hypoechogenicity affected the entire dermis in all cases of lymphoedema except one. In cases of lipoedema and controls, hypoechogenicity was localized at the ankle and prevailed in the upper dermis. The expert correctly diagnosed all lower limbs with lymphoedema. No cases of lipoedema were diagnosed as lymphoedema. Exact interobserver agreement was excellent (0·98).</p><p><hi rend="bold">Conclusions </hi> High‐resolution cutaneous ultrasonography makes it possible to differentiate lymphoedema from lipoedema. Obtaining a reliable diagnosis through high‐resolution cutaneous ultrasonography might be valuable for improving the treatment of lipoedema and lymphoedema.</p></abstract><textClass><keywords xml:lang="en"><term xml:id="k1">diagnostic test</term><term xml:id="k2">high frequency</term><term xml:id="k3">imaging</term><term xml:id="k4">lipoedema</term><term xml:id="k5">lymphoedema</term><term xml:id="k6">ultrasound</term></keywords><classCode scheme="tocHeading1">Original articles</classCode><classCode scheme="tocHeading2">Clinical and laboratory investigations</classCode><classCode scheme="articleCategory">CLINICAL AND LABORATORY INVESTIGATIONS</classCode></textClass><langUsage><language ident="EN"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/21411E2E0A31CE465704101B812238CFE24071E3/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1365-2133</doi><issn type="print">0007-0963</issn><issn type="electronic">1365-2133</issn><idGroup><id type="product" value="BJD"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="BRITISH JOURNAL OF DERMATOLOGY">British Journal of Dermatology</title></titleGroup></publicationMeta><publicationMeta level="part" position="08102"><doi origin="wiley">10.1111/bjd.2010.163.issue-2</doi><numberingGroup><numbering type="journalVolume" number="163">163</numbering><numbering type="journalIssue" number="2">2</numbering></numberingGroup><coverDate startDate="2010-08">August 2010</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="10" status="forIssue"><doi origin="wiley">10.1111/j.1365-2133.2010.09810.x</doi><idGroup><id type="unit" value="BJD9810"></id></idGroup><countGroup><count type="pageTotal" number="6"></count></countGroup><titleGroup><title type="tocHeading1">Original articles</title><title type="tocHeading2">Clinical and laboratory investigations</title><title type="articleCategory">CLINICAL AND LABORATORY INVESTIGATIONS</title></titleGroup><copyright>© 2010 The Authors. Journal Compilation © 2010 British Association of Dermatologists</copyright><eventGroup><event type="firstOnline" date="2010-04-16"></event><event type="publishedOnlineFinalForm" date="2010-07-21"></event><event type="publishedOnlineAcceptedOrEarlyUnpaginated" date="2010-04-16"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.25 mode:FullText source:FullText result:FullText" date="2010-10-27"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:4.0.1" date="2014-03-15"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-15"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="296">296</numbering><numbering type="pageLast" number="301">301</numbering></numberingGroup><correspondenceTo>Laurent Machet.
E‐mail: <email normalForm="machet@univ-tours.fr">machet@univ‐tours.fr</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:BJD.BJD9810.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Accepted for publication <i>6 April 2010</i></unparsedEditorialHistory><countGroup><count type="figureTotal" number="2"></count><count type="tableTotal" number="3"></count></countGroup><titleGroup><title type="main">High‐resolution cutaneous ultrasonography to differentiate lipoedema from lymphoedema</title><title type="shortAuthors">M. Naouri <i>et al.</i></title><title type="short">Differentiating lipoedema from lymphoedema</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>M.</givenNames><familyName>Naouri</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>M.</givenNames><familyName>Samimi</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a2"><personName><givenNames>M.</givenNames><familyName>Atlan</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a3"><personName><givenNames>E.</givenNames><familyName>Perrodeau</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a4"><personName><givenNames>C.</givenNames><familyName>Vallin</familyName></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a2"><personName><givenNames>G.</givenNames><familyName>Zakine</familyName></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a1 #a5"><personName><givenNames>L.</givenNames><familyName>Vaillant</familyName></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a1 #a5"><personName><givenNames>L.</givenNames><familyName>Machet</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="FR"><unparsedAffiliation>Department of Dermatology, Université François Rabelais, CHRU de Tours, 37044 Tours Cedex 1, France</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="FR"><unparsedAffiliation>Department of Plastic Surgery, CHRU, Tours, France</unparsedAffiliation></affiliation><affiliation xml:id="a3" countryCode="FR"><unparsedAffiliation>Inserm CIC 202, Tours, France</unparsedAffiliation></affiliation><affiliation xml:id="a4" countryCode="FR"><unparsedAffiliation>Department of Radiology, CHRU, Tours, France</unparsedAffiliation></affiliation><affiliation xml:id="a5" countryCode="FR"><unparsedAffiliation>UMR, Inserm U930, CNRS ERL 3106, Tours, France</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">diagnostic test</keyword><keyword xml:id="k2">high frequency</keyword><keyword xml:id="k3">imaging</keyword><keyword xml:id="k4">lipoedema</keyword><keyword xml:id="k5">lymphoedema</keyword><keyword xml:id="k6">ultrasound</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Summary</title><p><b>Background </b> Lipoedema is an accumulation of fat abnormally distributed in the lower limbs, and lymphoedema is oedema caused by a deficiency of the lymphatic system. High‐resolution ultrasound operating at 20 MHz makes it possible to characterize dermal oedema.</p><p><b>Objectives </b> The purpose of our study was to demonstrate that high‐resolution ultrasound imaging of the skin can differentiate lipoedema from lymphoedema.</p><p><b>Methods </b> Sixteen patients with lymphoedema (22 legs), eight patients with lipoedema (16 legs) and eight controls (16 legs) were included. Patients with lipolymphoedema were excluded. Ultrasound examinations were carried out with a real‐time high‐resolution ultrasound device on three different sites for each lower limb. The images were then anonymized and examined by an independent dermatologist who was blind to the clinical diagnosis. A new series of images was examined by three dermatologists to check interobserver agreement.</p><p><b>Results </b> A significant difference in dermal thickness was observed between patients with lymphoedema and those with lipoedema and between patients with lymphoedema and controls. No significant difference in dermal thickness was shown between patients with lipoedema and controls at the thigh or ankle. Dermal hypo‐echogenicity was found in at least one of the three sites in 100% of patients with lymphoedema, 12·5% of cases with lipoedema and 6·25% of the controls. Hypoechogenicity affected the entire dermis in all cases of lymphoedema except one. In cases of lipoedema and controls, hypoechogenicity was localized at the ankle and prevailed in the upper dermis. The expert correctly diagnosed all lower limbs with lymphoedema. No cases of lipoedema were diagnosed as lymphoedema. Exact interobserver agreement was excellent (0·98).</p><p><b>Conclusions </b> High‐resolution cutaneous ultrasonography makes it possible to differentiate lymphoedema from lipoedema. Obtaining a reliable diagnosis through high‐resolution cutaneous ultrasonography might be valuable for improving the treatment of lipoedema and lymphoedema.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>Conflicts of interest None declared.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>High‐resolution cutaneous ultrasonography to differentiate lipoedema from lymphoedema</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Differentiating lipoedema from lymphoedema</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>High‐resolution cutaneous ultrasonography to differentiate lipoedema from lymphoedema</title></titleInfo><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Naouri</namePart><affiliation>Department of Dermatology, Université François Rabelais, CHRU de Tours, 37044 Tours Cedex 1, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Samimi</namePart><affiliation>Department of Dermatology, Université François Rabelais, CHRU de Tours, 37044 Tours Cedex 1, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M.</namePart><namePart type="family">Atlan</namePart><affiliation>Department of Plastic Surgery, CHRU, Tours, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">E.</namePart><namePart type="family">Perrodeau</namePart><affiliation>Inserm CIC 202, Tours, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C.</namePart><namePart type="family">Vallin</namePart><affiliation>Department of Radiology, CHRU, Tours, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">G.</namePart><namePart type="family">Zakine</namePart><affiliation>Department of Plastic Surgery, CHRU, Tours, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">L.</namePart><namePart type="family">Vaillant</namePart><affiliation>Department of Dermatology, Université François Rabelais, CHRU de Tours, 37044 Tours Cedex 1, France</affiliation><affiliation>UMR, Inserm U930, CNRS ERL 3106, Tours, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">L.</namePart><namePart type="family">Machet</namePart><affiliation>Department of Dermatology, Université François Rabelais, CHRU de Tours, 37044 Tours Cedex 1, France</affiliation><affiliation>UMR, Inserm U930, CNRS ERL 3106, Tours, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2010-08</dateIssued><edition>Accepted for publication 6 April 2010</edition><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">2</extent><extent unit="tables">3</extent></physicalDescription><abstract>Background Lipoedema is an accumulation of fat abnormally distributed in the lower limbs, and lymphoedema is oedema caused by a deficiency of the lymphatic system. High‐resolution ultrasound operating at 20 MHz makes it possible to characterize dermal oedema.</abstract><abstract>Objectives The purpose of our study was to demonstrate that high‐resolution ultrasound imaging of the skin can differentiate lipoedema from lymphoedema.</abstract><abstract>Methods Sixteen patients with lymphoedema (22 legs), eight patients with lipoedema (16 legs) and eight controls (16 legs) were included. Patients with lipolymphoedema were excluded. Ultrasound examinations were carried out with a real‐time high‐resolution ultrasound device on three different sites for each lower limb. The images were then anonymized and examined by an independent dermatologist who was blind to the clinical diagnosis. A new series of images was examined by three dermatologists to check interobserver agreement.</abstract><abstract>Results A significant difference in dermal thickness was observed between patients with lymphoedema and those with lipoedema and between patients with lymphoedema and controls. No significant difference in dermal thickness was shown between patients with lipoedema and controls at the thigh or ankle. Dermal hypo‐echogenicity was found in at least one of the three sites in 100% of patients with lymphoedema, 12·5% of cases with lipoedema and 6·25% of the controls. Hypoechogenicity affected the entire dermis in all cases of lymphoedema except one. In cases of lipoedema and controls, hypoechogenicity was localized at the ankle and prevailed in the upper dermis. The expert correctly diagnosed all lower limbs with lymphoedema. No cases of lipoedema were diagnosed as lymphoedema. Exact interobserver agreement was excellent (0·98).</abstract><abstract>Conclusions High‐resolution cutaneous ultrasonography makes it possible to differentiate lymphoedema from lipoedema. Obtaining a reliable diagnosis through high‐resolution cutaneous ultrasonography might be valuable for improving the treatment of lipoedema and lymphoedema.</abstract><subject lang="en"><genre>keywords</genre><topic>diagnostic test</topic><topic>high frequency</topic><topic>imaging</topic><topic>lipoedema</topic><topic>lymphoedema</topic><topic>ultrasound</topic></subject><relatedItem type="host"><titleInfo><title>British Journal of Dermatology</title></titleInfo><genre type="journal">journal</genre><subject><genre>article-category</genre><topic>CLINICAL AND LABORATORY INVESTIGATIONS</topic></subject><identifier type="ISSN">0007-0963</identifier><identifier type="eISSN">1365-2133</identifier><identifier type="DOI">10.1111/(ISSN)1365-2133</identifier><identifier type="PublisherID">BJD</identifier><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>163</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>296</start><end>301</end><total>6</total></extent></part></relatedItem><identifier type="istex">21411E2E0A31CE465704101B812238CFE24071E3</identifier><identifier type="DOI">10.1111/j.1365-2133.2010.09810.x</identifier><identifier type="ArticleID">BJD9810</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2010 The Authors. 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