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New Horizons of Adipose Tissue Disorders: From Hormonal Issues to...
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New Horizons of Adipose Tissue Disorders: From Hormonal Issues to Loose Connective Disease: 2nd Edition

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 30 October 2026 | Viewed by 12354

Special Issue Editors

Dr. Laura Patton

E-Mail Website
Guest Editor
Endocrinology and Lymphology Clinic, 38096 Vallelaghi, Italy
Interests: endocrinology
Special Issues, Collections and Topics in MDPI journals
Dr. Guido Gabriele

E-Mail Website
Guest Editor
Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
Interests: maxillofacial surgery; head and neck surgery; microsurgery; lymphedema; supramicorsurgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Adipose tissue disorders, especially regarding superficial adipose tissue or subcutaneous fibro-adipose tissue, and diseases involving the lymphatic system are not yet considered in the same manner as diseases of other organs or tissues by the medical/scientific community.

These disorders are therefore often not adequately studied by researchers and are underestimated, consequently becoming the prerogative of non-healthcare professionals who deal with aesthetic pathologies.

Nonetheless, many years have now passed since the new vision and redefinition of adipose tissue as one of the major endocrine organs and a very important connection network between other endocrine–metabolic systems and other organs and tissues of the organism, e.g., the effects of leptin on the central nervous system and the regulation of fertility.

From the data emerging from studies carried out on rare diseases of adipose tissue, lipedema and tissue alterations linked to lymphedema, it is increasingly relevant to consider these diseases as primitive, which could originate from the tissue itself and not always be linked to changes in body weight, hormones or metabolism, and as diseases that not only involve adipocytes, but also the loose connective tissue with the extracellular matrix, other non-adipocyte cells and the entire micro- and macro-vascular and lymphatic systems.

We warmly invite you and your colleagues to submit original research articles, reviews, systematic reviews, meta-analyses and brief reports that address issues related to the future management and understanding of adipose and lymphatic tissue diseases, in particular lipedema and rare diseases of adipose tissue, as well as the clinical evaluation and instrumental diagnosis, treatment, prognosis, follow-up and prevention of these diseases.

We have successfully published the first volume, and you can read the related publications through the following link: https://www.mdpi.com/journal/life/special_issues/6JGG8U233Y

Dr. Laura Patton
Dr. Guido Gabriele
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • adipose tissue
  • lipedema
  • lymphedema
  • obesity
  • matrix
  • vascular and lymphatic disorder
  • connective tissue diseases
  • dysbiosis
  • inflammation
  • pain

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Published Papers (4 papers)

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Research

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20 pages, 2865 KB  
Article
Dercum Disease: Exploratory Therapeutic Approaches in the Absence of Standardized Medical Treatment—A Single Center Case Series
by Alessandro Magnatta, Alice Verdelli, Virginia Corti, Luca Sanna, Manfredi Magliulo, Valentina Ruffo di Calabria, Elisabetta Magnaterra, Elena Biancamaria Mariotti, Simone Landini, Rachel Daher, Irene Bonanni, Marta Donati, Francesca Gorini, Alessio Coi, Ilaria Di Donato, Cinzia Pupilli and Marzia Caproni
Life 2026, 16(4), 582; https://doi.org/10.3390/life16040582 - 1 Apr 2026
Viewed by 601
Abstract
Dercum’s disease (DD) is a rare chronic disorder characterized by painful subcutaneous lipomas, mostly affecting overweight or obese middle-aged women. The etiology remains unclear, and evidence for medical treatments is limited. Surgical approaches may reduce pain but are associated with frequent relapses and [...] Read more.
Dercum’s disease (DD) is a rare chronic disorder characterized by painful subcutaneous lipomas, mostly affecting overweight or obese middle-aged women. The etiology remains unclear, and evidence for medical treatments is limited. Surgical approaches may reduce pain but are associated with frequent relapses and are difficult to implement in extensive clinical pictures. We investigated the outcomes of multiple medical and surgical therapeutic strategies. Particularly, we explored immunomodulators (methotrexate and infliximab), used alone or combined with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) such as semaglutide, as well as the dual GIP (glucose-dependent insulinotropic polypeptide)/GLP-1 RAs tirzepatide. Five patients with DD were included in this retrospective single-center case series. Baseline clinical data, medical history, and longitudinal information on Dermatology Life Quality Index (DLQI), Visual Analogue Scale (VAS) for pain, and body mass index (BMI) were collected from existing medical records and scheduled follow-up visits conducted since 2021. Clinical trajectories differed across patients and regimens. Methotrexate and infliximab coincided with variable and often transient improvements in pain and quality of life. Combination regimens including GLP-1 RAs were accompanied by weight reduction and, in selected patients, by sustained improvements in pain and DLQI. In other cases, the benefit was limited or absent. Adverse events were manageable and consistent with the known safety profiles of these drugs. In this small real-world case series, therapeutic responses in DD were highly individualized, underscoring the absence of standardized medical treatment and the need for patient-tailored strategies. The observed patterns suggest that immunomodulatory and incretin-based therapies may represent exploratory options in selected patients, especially when surgery is not feasible. However, controlled studies are needed to clarify their role. Full article
(This article belongs to the Special Issue New Horizons of Adipose Tissue Disorders: From Hormonal Issues to Loose Connective Disease: 2nd Edition)
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16 pages, 2586 KB  
Article
New Characterization of Lipedema Stages: Focus on Pain, Water, Fat and Skeletal Muscle
by Sara Al-Ghadban, Jane V. Evancio, Paula E. F. Alfiscar and Karen L. Herbst
Life 2025, 15(9), 1397; https://doi.org/10.3390/life15091397 - 3 Sep 2025
Cited by 5 | Viewed by 9738
Abstract
Lipedema is a chronic, progressive adipose connective tissue disorder characterized by symmetrical, disproportionate fat accumulation, typically affecting the lower extremities and arms, accompanied by pain, swelling, and a sensation of heaviness. This study introduces intermediate Stages 1.5 and 2.5 to the established lipedema [...] Read more.
Lipedema is a chronic, progressive adipose connective tissue disorder characterized by symmetrical, disproportionate fat accumulation, typically affecting the lower extremities and arms, accompanied by pain, swelling, and a sensation of heaviness. This study introduces intermediate Stages 1.5 and 2.5 to the established lipedema classification (Stages 1, 2 and 3), and other affected areas, based on physical examination, a questionnaire, and photographic documentation. Bioelectrical Impedance Spectroscopy (BIS) was employed to quantify total body water (TBW) across stages. A significant and linear increase in BMI was observed from Stage 1 to 3, correlating with increased reported pain and heaviness in the thighs, calves, and upper arms. Systemic symptoms of brain fog, debilitating fatigue, and hypothermia were significantly prevalent. TBW demonstrated a significant, stage-dependent increase in the lower extremities. Adipose tissue accumulation over the knees and feet significantly increased with lipedema stage. In contrast, shin involvement was evident in early stages and remained consistently elevated throughout later stages. Skeletal Muscle Mass (SMM) exhibited a significant increase across lipedema stages, positively correlating with fat mass (FM) in Stage 3. This study elucidates previously underrecognized clinical features and distribution patterns of lipedema, offering a refined staging system to improve understanding of its progression and burden. Full article
(This article belongs to the Special Issue New Horizons of Adipose Tissue Disorders: From Hormonal Issues to Loose Connective Disease: 2nd Edition)
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Review

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23 pages, 600 KB  
Review
Dercum’s Disease: Bridging Present Understanding and Emerging Directions
by Francesca Gorini, Alessio Coi, Alice Verdelli, Elisabetta Magnaterra, Manfredi Magliulo, Luca Sanna, Virginia Corti, Simone Landini, Marta Donati, Irene Bonanni, Rachel Daher, Alberto Corrà, Cinzia Pupilli, Elena Biancamaria Mariotti, Valentina Ruffo di Calabria, Alessandro Magnatta and Marzia Caproni
Life 2026, 16(2), 290; https://doi.org/10.3390/life16020290 - 8 Feb 2026
Viewed by 1254
Abstract
Dercum’s disease (DD) is a rare condition characterized by intense, asymmetrical, chronic burning pain localized in adipose tissue, often accompanied by subcutaneous fat nodules, leading to a significant reduction in quality of life. It typically affects overweight or obese adults between 35 and [...] Read more.
Dercum’s disease (DD) is a rare condition characterized by intense, asymmetrical, chronic burning pain localized in adipose tissue, often accompanied by subcutaneous fat nodules, leading to a significant reduction in quality of life. It typically affects overweight or obese adults between 35 and 50 years of age, with a marked female predominance. Despite numerous hypotheses proposed over time, the pathophysiology of DD remains poorly understood. Diagnosis is particularly challenging, as it relies solely on clinical evaluation. Given the overlapping features with other conditions, including symptoms, clinical course and inheritance pattern, a differential, accurate, and timely diagnosis is essential for the effective management of DD. Current treatment strategies focus primarily on pain relief, reflecting the still uncomplete understanding of DD etiopathogenesis. This review provides an updated overview of the current knowledge on DD, with particular emphasis on recent advances in pharmacological treatment strategies. Full article
(This article belongs to the Special Issue New Horizons of Adipose Tissue Disorders: From Hormonal Issues to Loose Connective Disease: 2nd Edition)
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Other

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6 pages, 1773 KB  
Case Report
Nevus Lipomatosus Superficialis with Mixed Morphologic Features: Gross, Sonographic, and Histopathologic Correlation
by Michelle T. Nguyen, Leo P. Wu and Grant M. Pham
Life 2026, 16(4), 693; https://doi.org/10.3390/life16040693 - 21 Apr 2026
Viewed by 204
Abstract
Nevus lipomatosus superficialis (NLS) is an uncommon benign hamartoma characterized by ectopic adipocytes within the dermis and may present with features that overlap clinically with other soft, pedunculated, or cerebriform lesions. We report a rare presentation with mixed morphologic traits that created diagnostic [...] Read more.
Nevus lipomatosus superficialis (NLS) is an uncommon benign hamartoma characterized by ectopic adipocytes within the dermis and may present with features that overlap clinically with other soft, pedunculated, or cerebriform lesions. We report a rare presentation with mixed morphologic traits that created diagnostic uncertainty on gross examination. The lesion demonstrated atypical surface contour and texture, prompting multimodal evaluation to clarify the differential diagnosis and support safe outpatient management. Point-of-care ultrasound (POCUS) was used to evaluate lesion architecture and vascularity. Findings provided real-time, noninvasive support for benign morphology and informed procedural planning. Subsequent histopathologic analysis established the diagnosis by demonstrating dermal adipose deposition consistent with NLS. This case underscores the value of integrating gross examination with sonographic assessment and histopathology when cutaneous lesions have overlapping clinical features. In addition, it contributes to the limited literature describing ultrasound findings in NLS. Incorporating POCUS into the assessment of atypical cutaneous growths may improve diagnostic confidence, reduce unnecessary escalation of care, and support efficient, safe treatment in outpatient settings. Full article
(This article belongs to the Special Issue New Horizons of Adipose Tissue Disorders: From Hormonal Issues to Loose Connective Disease: 2nd Edition)
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