Barriers to quality oral health care among elderly (Geriatric) patients in Oyo State.

Lipedema is a chronic, progressive, and multifactorial condition that predominantly affects women. It is characterized by an abnormal and symmetrical accumulation of subcutaneous adipose tissue, primarily in the lower extremities, hips, and arms, with little or no involvement of the hands and feet. This accumulation is typically resistant to volume reduction, even following interventions such as dietary modifications, physical exercise, and, in some cases, traditional bariatric surgery, making both diagnosis and treatment challenging. Although initially described by Irving Phillips Lyon in 1910 and later detailed by Allen and Hines in 1940, lipedema was only officially recognized as a distinct disorder of subcutaneous fat in 2022, with its inclusion in the 11th Revision of the International Classification of Diseases (ICD-11) under codes EF02.2 and BD93.1Y. The estimated prevalence of lipedema ranges from 0.06% to 11% in the general female population, with higher rates reported in countries such as Germany (39%) and Brazil (12.3%). Recent population-based data suggest that approximately 8.8 million Brazilian women aged 18 to 69 years may have symptoms suggestive of lipedema. The etiology of lipedema remains uncertain, although its multifactorial nature is recognized. Genetic predisposition with an autosomal dominant inheritance pattern has been frequently reported, with a positive family history identified in up to 60% of cases. Hormonal changes, particularly estrogen-related dysfunctions in adipocytes (such as hypertrophy and hyperplasia), and microvascular alterations involving lymphatic and blood capillaries have also been proposed as pathophysiological mechanisms.