CC-03   LIPEDEMATOUS SCALP: CASE REPORT

I. Bukhari, F. Almulhim, R. Alhoqail. King Faisal University, College of Medicine and Medical Sciences, Alkhobar, Saudi Arabia.

Lipedematous scalp means the accumulation of excess fat and fluid in the subcutaneous tissue of the scalp without alopecia. While lipedematous alopecia is a condition that occurs in African-origin women who present with alopecia besides the thickened scalp. Here we present the second report in the literature of lipedematous scalp in a 57-year-old Saudi woman who presented to the dermatology clinic with a gradual diffuse swelling and heavy feeling all over her scalp since six months. There was no history of hair loss or pain or trauma in the head. Besides, the patient had supraventricular tachycardia and hypercholestermia on treatment for the past eight years. On examination: The scalp was smooth, remarkably thick, spongy, fluctuant on palpation but not tender. No inflammation or irregularities were detected. Hair density and length were normal. An incisional biopsy revealed a remarkable increase in the thickness of the subcutaneous fat layer with normal epidermal and dermal layers. CT scan of the skull showed scalp thickness of 16.9-21.2 mm at the high occipitoparietal region with subcutaneous fat being 19.2 mm. So the patient was diagnosed as a case of lipedematous scalp. Discussion: Many reports of lipedematous alopecia has been presented in the literature but one case of lipedematous scalp was reported in a Korean female which was similar to our case. Basically, the normal scalp thickness in an adult person is about 5.8 mm. In the present case the scalp thickness was in the range of 16.9-21.2 mm with subcutaneous fat layer being 19.2 mm which is significantly increased. The pathologic process consists of enlarged subcutaneous fat deposits associated with edema. Unfortunately, the exact pathogensis of this process is not yet known but possibly the hyperlipidemia might play a role although it was not reported previously. It is still unknown whether lipedematous alopecia and lipedematous scalp are two distinct entities or represent a spectrum of one disease. Further studies are needed to clarify that for us so effective treatment can be established.