Plate 15

        

Lipomatosis perimuscularis circumscripta.

Side and front perspectives of a case somewhat lesser advanced than Fig.13, but more characteristic.

48 year old worker; slow sustained development of this affliction over the course of the last year. Nothing similar could be found in the parents and the rest of the family.

The side view shows the excrescent bull neck of case 13 again and the hypertrophy of the adipose tissue, simulating an overdevelopment of the deltoideus, biceps and triceps. A similar growth of the panniculus is shown over the muscles of the chest and those of the abdomen; especially over the rectus abdominus again. The forearm and the lower extremities up to the region of the tensor fasciae latae and the upper extension of the triceps are completely free of fatty hyperplasia. They may be recognized as perfectly normal, massively developed musculature.

Also incidental to this case (as the image from the side clearly shows) the forward portion of the left deltoideus presented already entrenched atrophic areas of the fatty hyperplasia, in which the muscle was palpably attenuated and limp.

The frontal view of the case shows the perfect symmetry of fatty hyperplasia in reference to both dispersion and growth. Like the previous patient, it is also indicated by the sallow color of the face and delapidated features. In the areas of the body without lipomatosa the skin was thin and noticeably dry.






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