Brodie's Disease-Madelungs Fetthals-Launois Bensaude's Lipomatosis-MSL
Prof. Camillo O. DI CICCO, M.D. XIth Congress of the European Academy of Dermatology and Venereology, Prague. The first studies of the disease go back to 1846 by B.C. Brodie, which describes a picture of lipomatosis symmetrical disseminated with interest of the neck in the job " Clinical Lectures on Surgery, Delivered at St George's Hospital " Philadelphya, Lea and Blanchard (pub) 1846 Pp 201-210. Subsequently such picture was described from Huguier (1855)), Founder (1863) and Vermeuil (1888). In the same year Otto W. Madelung has accurately described the symptomatology in very 33 clinical cases[ Ueber den Fetthals: Diffuse Lipom des Halses: (von Langenbeck's) Archiv fur Klinische Surgeries, Berlin, 1888,37:106-130]. In the following years were published several jobs by Bucquoy, Dartignolles and Lèjars (1892), Koettnitz (1894), Payr (1895), Lowenthal(1896), Dalchè and Hayem (1897), Preyss (1898). In 1898 with the detailed description of 75 clinical cases in "De adénolipomatose simmétrique" (Bull.Soc.Mèd.Hop.Paris,Mémoires,1898,1:298-318), P.E. Launois and R. Bensaude defined clearly such rare disease. The clinical picture of the disease is characterized from the presence of symmetrical multiple masses of fat, painless, on the neck, upper trunk, arms and legs. This disease is more frequent in the Mediterranean area, in the male sex and in chronic alcoholic. In the clear shape introduces a neck wrapped from deposits of fat. To level of the limbs a fondness of the lipomatose masses to the root saving the distant segments is determined, creating in such a way an pseudoathletic, massive aspect that resembles the Italic statue of 6th century B.C. "Capestrano Warrior", discovered in Abruzzo (Italy). To the museum of Cairo, in Queen Hatshepsut's tomb in Deir el Bahari, Queen of Punt, who died nearly 34 centuries ago, shows lined face, gluteo-femoral obesity, hyperlordosis and symmetrical deposits of fat on the trunk, limbs and thighs. Sometimes are present vertebral and neurologic lesions (radicular jams, marrow's degeneration). The disease regards in particular men beyond the 40 years of age ( the cases published from Madelung referred exclusively to the male sex), heavy jobs and chronic alcoholic. Surgical participation can determine an remarkable increase of the lipomatose masses (dyspnea, peripheral neuopathy). The histology introduces woven normal adipose tissue which in its evolution, consequently surgical-trauma, can become inter-intra muscular. Therefore it is advised abstain from surgical exeresis while moreover the liposuction is advisable.