Supra pubic fat pad

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Italian researchers have finally discovered what has been obvious for years to many of us lipodystrophites (my term) - a surpra pubic fat pad is often part of the lipo syndrome. There were recent questions and answers about this on this group, but we only had personal anecdotes. Mine appeared in 1999 as part of the rapid fat loss/fat gain after a year on Zerit. (By the way, I'm neither female, obese, nor short term HIV). Now it is clear that this symptom is rather common. The researchers point out that it has been missed because of failure to exam patients in the nude. Another example perhaps of too-short exams and assembly line medicine. I had a dermatologist a few years ago who failed to ask me to disrobe completely, although I knew that in dermatology especially a total skin exam is considered standard of care. I am surprised that HIV doctors with large practices haven't reported this already.NEW

YORK (Reuters Health) May 15 - A distinctive suprapubic fat pad is often present in patients with HIV-associated lipodystrophy, but it is often overlooked, Italian researchers report in the May 1st issue of the Journal of Acquired Immune Deficiency Syndrome. Dr. Giovanni Guaraldi, of the University of Modena and Reggio Emilia School of Medicine in Modena, and colleagues evaluated 582 patients with HIV infection and lipodystrophy. A little more than one-third of the patients were female. The overall prevalence of pubic lipoma, which the team describes as "a novel clinical manifestation of lipoaccumulation," was 9.4%. "A possible reason for its not having been previously described is that its clinical detection is most readily accomplished when patients are naked and standing," the team observes. Pubic lipomas were present in 34.5% of obese patients compared with only 8.0% of nonobese patients. They were present in 18.5% of

patients with dorsocervical fat pads ("buffalo humps") but in only 6.1% of those without them. Dr. Guaraldi and colleagues suspect that there is a common pathogenesis between dorsocervical and suprapubic fat pads. Obesity, female gender and shorter duration of HIV infection were all risk factors for pubic lipomas. They recommend that pubic lipomas be considered part of the HIV-related lipodystrophy syndrome, saying, "the robustness of our findings, particularly a 9.4% prevalence rate ... underscore their significance and are unlikely to comprise a merely casual association with known HIV-associated body habitus changes." J Acquir Immune Defic Syndr 2007;45:72-76.

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