Lipedema. Lipedema, also known as lipomatosis of the leg, is a chronic progressive disorder of the adipose tissue. It is often misdiagnosed as primary lymphedema.00 It occurs almost exclusively in women, and most commonly arises within a few years after theonset of puberty.00 It manifests as bilateral symmetrical accumulation of subcutaneous fat, mainly in the lower extremities, and presents with tenderness, easy bruising, and the tendency for leg swelling that worsens with standing.00,00 One distinctive feature is that the swelling stops abruptly at the level of the malleoli. Easy bruising is related to increased fragility of capillaries within the adipose tissue.00 Lipedema can cause lymphatic dysfunction at a later stage.00 Key features to differentiate lipedema from lymphedema are outlined in Table III.