{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:30:56Z","timestamp":1792153856450,"version":"4.4.0"},"reference-count":74,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Lipedema is a chronic, underdiagnosed adipose disorder marked by disproportionate fat accumulation, pain, and impaired mobility. Misdiagnosis as obesity or lymphedema delays care and increases morbidity. We systematically reviewed clinical features, diagnostic criteria, and management options (conservative and surgical). A comprehensive search of the PubMed database was conducted in January 2025 for English\u2010language articles published from January 1950 to January 2023 using the keywords \u201clipedema\u201d or \u201clipoedema.\u201d Additional references were identified via manual review of relevant systematic reviews. Two independent reviewers screened studies and graded quality using a modified Oxford scale. Of 339 articles, 61 met the inclusion criteria. Most were observational cohorts, case series, or expert consensus, with few randomized trials. Conservative therapies, including ketogenic or Rare Adipose Disorders (RAD) diets, compression therapy, and aquatic exercise, were associated with reduced pain and swelling (Grade 2A\u20132B). Tumescent liposuction showed the strongest evidence for sustained symptom improvement, mobility, and quality of life (Grade 1 recommendation, evidence quality 2\u20133). Lipedema is a distinct, progressive condition requiring early recognition and intervention. Conservative therapies may provide partial relief, but tumescent liposuction remains the most effective treatment. Standardized diagnostic criteria, validated patient\u2010reported outcomes, and clearer guidelines are needed to harmonize care and improve long\u2010term outcomes.<\/jats:p>","DOI":"10.1111\/ijd.70227","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T10:22:42Z","timestamp":1767781362000},"page":"1811-1819","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Lipedema Diagnosis, Clinical Manifestations, and Therapeutics: A Systematic Review"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5421-7323","authenticated-orcid":false,"given":"Aria","family":"Vazirnia","sequence":"first","affiliation":[{"name":"The Roxbury Institute  Los Angeles Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Smart","sequence":"additional","affiliation":[{"name":"The Roxbury Institute  Los Angeles Utah USA"},{"name":"Department of Dermatology University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3150-4505","authenticated-orcid":false,"given":"Yasmine","family":"Mohseni","sequence":"additional","affiliation":[{"name":"Department of Medical Education University of Miami Miller School of Medicine  Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Amron","sequence":"additional","affiliation":[{"name":"The Roxbury Institute  Los Angeles Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/S0025-6196(25)37697-4","article-title":"Lipedema of the Legs: A Syndrome Characterized by Fat Legs and Orthostatic Edema","volume":"15","author":"Allen E. 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