Selective and variable adipose tissue loss in partial and generalized lipodystrophy syndromes

Patients with congenital generalized, familial partial, and acquired lipodystrophies display selective and variable adipose tissue loss. (A) CGL1 and CGL2 may present with a generalized lack of fat; extreme muscularity; acanthosis nigricans in the groin, abdomen, or axillae; and acromegaloid features. (B) Familial partial lipodystrophy such as the Dunnigan variety may manifest as loss of fat from the trunk and upper and lower extremities and excess fat accumulation in the face and neck. (C) Other familial partial lipodystrophies are characterized by loss of fat from the face, neck, arms, and legs and excess fat accumulation in the trunk. (D) Similarly, acquired lipodystrophy associated with HIV infection may display as loss of fat from the face, arms, and legs; in certain cases, increased abdominal fat; and a "buffalo hump." (E) Acquired partial lipodystrophy is characterized by loss of subcutaneous fat from the face, neck, arms, thorax, and abdomen and simultaneously excessive amounts of subcutaneous fat in the legs. (F) Acquired generalized lipodystrophy is characterized by loss of fat from large areas of the body, particularly the face, arms, and legs.