Concave cheeks and temples on both sides

Introduction The facial manifestations of patients with progressive lipodystrophy are concave on both sides of the cheeks and ankles, the skin is slack, and the normal elasticity is lost. The disappearance of fat around the cheeks and eyelids gives the patient a special face. Some patients may have obvious subcutaneous tissue hyperplasia and hypertrophy in the buttocks and hips, but the hands and feet are often unaffected.

Cause

(1) Causes of the disease

The cause is unknown. Due to damage to the midbrain and the diencephalon, the anterior pituitary hormone secretion is increased or the mesodermal interstitial function is disordered. Sissons found that some patients had glomerulonephritis and low complement (C3)emia. A small number of patients have a family history.

(two) pathogenesis

Mainly associated with hypothalamic lesions and post-ganglionic sympathetic neuropathy in parallel with the spinal nerve. The hypothalamus plays a regulatory role in gonadotropins, thyroid stimulating hormones and other endocrine glands, and is closely related to the post-ganglionic sympathetic nerve fibers. There seems to be a boundary between the disappearance zone of adipose tissue of the progressive lipodystrophy and the normal zone or the obese zone. This boundary has a certain relationship with the segment of the spinal cord. Usually, the body is divided into the upper body and the lower body with the waist 1 to 2 as the boundary. Two parts.

Another study suggests that the hypothalamic and pituitary constitute a metabolic regulation control system, and fat loss is related to the promotion of fat transfer factors produced by the system. Before the onset, there may be a history of acute fever and endocrine defects, such as hyperthyroidism, hypopituitarism and encephalitis. Injury, mental factors, early menstruation and pregnancy may all be incentives. At present, the view on the role of genetic factors has not been unified. .

an examination

Related inspection

Electromyography facial nerve examination

Laboratory tests revealed elevated serum chylomicrons, pre-beta lipoproteins, and triglycerides. 70% of patients had a decrease in C3 and 90% had a change in nephritis.

1. Skin and subcutaneous tissue biopsy showed subcutaneous adipose tissue atrophy and normal skin.

2. Electromyography shows normal muscle and nerves.

3. B-ultrasound can be found that the affected organs shrink and become smaller.

Differential diagnosis

Need to be identified with the following symptoms:

Fat Metabolism: Fat metabolism is also called fat redistribution, a disorder in your body that produces, uses, and stores fat. There are two different fat transfers. One is that fat loss is also called muscle atrophy, and fat is lost from some part of the body, especially arms, legs, face and buttocks. The other is fat accumulation, also called obesity. Fat accumulates in specific parts of the body, especially the stomach, chest and back neck.

The disappearance of cheek fat is the face of the elderly: it is one of the symptoms of congenital hypertrophic pyloric stenosis. The patient showed malnutrition, reduced subcutaneous fat, loose skin, dryness, wrinkles, loss of elasticity, depression of the front and eye sockets, and loss of cheek fat, showing the face of the elderly. Congenital hypertrophic pyloric stenosis (CHPS) is a mechanical pyloric obstruction caused by pyloric ring muscle hypertrophy and hyperplasia, which is a common disease in neonates and infants. Most of them are full-term children, and the success of the treatment of pyloric stenosis is one of the great achievements of surgery in this century. Subcutaneous fat atrophy: also known as subcutaneous fat atrophy, fat dystrophy. In 1885, Weir-Miechell first reported partial lipodystrophy (lipodystrophy), and later reported that the patient had neck, arms, chest and abdomen fat malnutrition, with increased fat deposition in the hips and legs, Lawrence reported in 1946 Complete fat dystrophy, patients with malnutrition are systemic, completely or patchy, and fat deficiency is often accompanied by a series of metabolic disorders.

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