Cellulite: nature and aetiopathogenesis (original) (raw)

The Pathophysiology of Cellulite: Can the Puzzle Eventually Be Solved

The pathophysiology of cellulite is still largely unknown. Here, we propose a new pathophysiology that connects the development of cellulite with several newly-discovered hallmarks of white adipose tissue. According to this theory, cellulite appears in hypertrophic fat tissue that is associated with overproduction of low molecular weight hyaluronan (HA). This can induce different types of fibrosis, producing inhomogeneous spatial tension in the tissue. This patho-physiology serves to explain the most well known peculiarities of cellulite appearance as well as to formulate the theoretically optimal cellulite treatment strategy.

Cellulite: a review of its physiology and treatment

Journal of Cosmetic and Laser Therapy, 2004

Cellulite affects 85-98% of post-pubertal females of all races. While not a pathologic condition, it remains an issue of cosmetic concern to a great number of individuals. Despite its high prevalence, there have been few scientific investigations into the physiology of ...

Cellulitis A Review Clinical Review & Education Review

C ellulitis is a bacterial infection of the skin, presenting with poorly demarcated erythema, edema, warmth, and tenderness. Although common, it often can be a diagnostic and therapeutic challenge. In this review, the pathophysiology, microbiology , clinical presentation, and risk factors of cellulitis are discussed. The approach to diagnosis is reviewed and the importance of differentiating cellulitis from clinical mimics of cellulitis is highlighted. An approach to empirical treatment is presented, with recent recommendations from the literature. Methods A literature search of the entire PubMed database was conducted with search terms and synonyms for cellulitis. The search was performed on October 9, 2014, and repeated on August 28, 2015. The initial search identified 10 154 articles and the updated search identified an additional 306. Studies published in non-English languages (unless translated), and studies involving exclusively children or animals were excluded. Meta-analyses, systematic reviews, references cited in published clinical practice guidelines, and antibiotic reference tools were also reviewed. Bibliographies of the retrieved studies and previous reviews were searched for other relevant studies. Initially, 595 articles were identified for full review, and of these, the most pertinent 125 were selected for inclusion. Articles were reviewed for the quality of evidence and contribution to current understanding of cellulitis, with priority given for clinical trials, large observational studies, and more recently published articles. Results Epidemiology The majority of epidemiology studies on cellulitis rely on International Classification of Diseases, Ninth Revision, codes (ie, 681.x and 682.x) that unfortunately link cellulitis and abscess, creating some limitations. However, these data remain valuable by providing a general scope of the problem and trends over time. Cellulitis or abscess is a common diagnosis whose incidence is increasing and accounted for 10% of infectious disease-related US hospitalizations from 1998 to 2006, 1 with annual US ambulatory IMPORTANCE Cellulitis is an infection of the deep dermis and subcutaneous tissue, presenting with expanding erythema, warmth, tenderness, and swelling. Cellulitis is a common global health burden, with more than 650 000 admissions per year in the United States alone. OBSERVATIONS In the United States, an estimated 14.5 million cases annually of cellulitis account for $3.7 billion in ambulatory care costs alone. The majority of cases of cellulitis are nonculturable and therefore the causative bacteria are unknown. In the 15% of cellulitis cases in which organisms are identified, most are due to β-hemolytic Streptococcus and Staphylococcus aureus. There are no effective diagnostic modalities, and many clinical conditions appear similar. Treatment of primary and recurrent cellulitis should initially cover Streptococcus and methicillin-sensitive S aureus, with expansion for methicillin-resistant S aureus (MRSA) in cases of cellulitis associated with specific risk factors, such as athletes, children, men who have sex with men, prisoners, military recruits, residents of long-term care facilities, those with prior MRSA exposure, and intravenous drug users. Five days of treatment is sufficient with extension if symptoms are not improved. Addressing predisposing factors can minimize risk of recurrence. CONCLUSIONS AND RELEVANCE The diagnosis of cellulitis is based primarily on history and physical examination. Treatment of uncomplicated cellulitis should be directed against Streptococcus and methicillin-sensitive S aureus. Failure to improve with appropriate first-line antibiotics should prompt consideration for resistant organisms, secondary conditions that mimic cellulitis, or underlying complicating conditions such as immunosuppression, chronic liver disease, or chronic kidney disease.

Proteomic and Ultrastructural Analysis of Cellulite—New Findings on an Old Topic

International Journal of Molecular Sciences

Background: Cellulite is a condition in which the skin has a dimpled lumpy appearance. The main causes of cellulite development, studied until now, comprehends modified sensitivity to estrogens, the damage of microvasculature present among dermis and hypodermis. The differences of adipose tissue architecture between male and female might make female more susceptible to cellulite. Adipose tissue is seen to be deeply modified during cellulite development. Our study tried to understand the overall features within and surrounding cellulite to apply the best therapeutic approach. Methods: Samples of gluteal femoral area were collected from cadavers and women who had undergone surgical treatment to remove orange peel characteristics on the skin. Samples from cadavers were employed for an accurate study of cellulite using magnetic resonance imaging at 7 Tesla and for light microscopy. Specimens from patients were employed for the proteomic analysis, which was performed using high resolutio...

The Epidemiological Study, Clinical Signs, Complications, and Treatment of Cellulities in Children

Journal of Vessels and Circulation, 2021

Background and Aim: Cellulite is the most common soft tissue infection in children. Children are prone to cellulite because they are more disposed to trauma, insect or animal bites, wounds, and scratches. This study aimed to determine the frequency of causes, complications, and cellulite treatment in children referred to Hazrat Masoumeh Hospital in Qom City, Iran. Materials and Methods: This descriptive study was performed on all patients admitted to Hazrat Masoumeh Hospital in Qom during 2013-2020. The study data were extracted from patients’ medical records and statistically analyzed. Results: The Mean±SD age of the patients was 42.94±38.15 months. Their male/female sex ratio was almost one. The most affected areas were the lower extremities (43%), the upper extremities (26.5%), and the face and eyes (6.6%). The most common clinical manifestations were edema (75%), redness (62%), and fever (38%). The most commonly prescribed antibiotics were ceftriaxone (47%), cloxacillin (34.7%),...

Case Report on Cellulitis

Journal of Pharmaceutical Research International, 2021

Introduction: Cellulitis is a bacterial infection that causes an inflammatory condition of the skin that affects the dermis and subcutaneous tissues. 2016 (Lee and Levell). Cellulitis of the lower limbs is a potentially dangerous condition (Halpern et al, 2008). Rubor or erythema, which is warm to the touch and often combined with a degree of localised oedema, is the most common symptom. However, because diagnosis is dependent exclusively on clinical data, it is commonly misdiagnosed [1]. There are a number of different illnesses that have symptoms that are similar to cellulitis. The purpose of this page is to provide information on the clinical symptoms of lower limb cellulitis as well as treatment options ensuring that practitioners are capable of making an accurate diagnosis and developing successful treatment programmes [2]. Clinical Findings: Fever, pain over right lower leg, wound present right dorsal foot, weariness, malaise, and swelling were the patient’s main complaints. D...

Clinical Study on Cellulitis in a Tertiary Centre

PARIPEX INDIAN JOURNAL OF RESEARCH

INTRODUCTION: Cellulitis is a non-suppurative, invasive infection caused by bacteria that is characterized by specifically affecting the dermis and subcutaneous fatty layer by normal skin flora or exogenous bacteria. The lower limbs are affected commonly following a breach due to cracks, breaks, blisters, surgical wounds, ulcers in the skin. Untreated conditions will lead to sequential changes causing severe morbidity and sometimes mortality. AIM: To study the age and sex distribution, risk factors, treatment modalities of patients admitted as cellulitis cases in Department of General Surgery,Government Tirunelveli Medical College Hospital from August 2017 to February 2018. RESULTS: In this study on 100 patients, 76 had lower limb cellulitis and 24 had upper limb cellulitis. Age group commonly affected was from 40 - 60 yrs of age.Most of the patients had Grade III cellulitis. Among the patients with risk factors of Diabetes mellitus, snake bites, the site of bite or the toes or the ...