Massive Obesity Simulating Lymphedema

To the Editor: The images of massive obesity simulating lymphedema (Dec. 31 issue)¹ are quite impressive. The photograph clearly shows the condition of lipomatosis of the legs, also known as lipedema. When confined to the thighs, the condition is known as “riding-breeches thighs.” When involving the whole leg, it is known as either “billiard-table legs” or “stovepipe legs.” If lymphedema were the cause of this degree of leg swelling, there would also be pitting or spreading edema on the dorsum of either foot in response to pressure, with the chronic skin changes of hyperkeratosis and increased skin markings. None of…