The loss of adipose tissue from the hypodermis and surrounding tissue.
Facial lipoatrophy occurs naturally with aging and in patients on antiretroviral treatment for HIV.
Of the face typical occurs in the buccal, temporal and subzygomatic areas, but can also be seen at the periorbital, frontal and perioral sites.
Loss of subcutaneous fat most evident in face, limbs, with prominence of veins, and buttocks.
Can manifest as loss of fat in the limbs, buttocks, abdomen with visual prominence of extremity veins, pseudomegaly.
Among nucleoside analogues stavudine associated with higher risk of clinical lipoatrophy and more rapid loss of limb fat than zidovudine, abacavir or tenofovir.
Patients with moderate to severe disease have limb mass of about 50% below that of normal individuals, with a normal limb fat mass of 8 kg or more.
Stavudine is the agent associated with the highest risk.