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BASIC AND CLINICAL DERMATOLOGY - PART 2

Các tổn thương về cơ bản không có triệu chứng. Tuy nhiên, trong một mức độ tiên tiến của cellulite, các triệu chứng như cảm giác về trọng lượng và đau có thể xảy ra ở các khu vực bị ảnh hưởng (10,20,29). Này có thể xảy ra như là một kết quả nén của các thiết bị đầu cuối thần kinh hoặc sự hiện diện của các phản ứng viêm | DEFINITION CLINICAL ASPECTS ASSOCIATED CONDITIONS AND DIFFERENTIAL DIAGNOSIS 11 The lesions are essentially asymptomatic. However in an advanced degree of cellulite symptoms such as a sensation of weight and pain may occur in the affected areas 10 20 29 . These probably occur as a result of compression of the nervous terminals or the presence of inflammatory reactions 16 19 . The main manifestations of clinical cellulite are 1. flaccid mattress-like skin with multiple depressions and some elevations caused by irregular retraction of the skin forming a surface where protuberances and depressed areas alternate Fig. 1 6 16 34 2. orange peel skin due to the tumefaction of the epidermis and dilation of follicular pores 6 16 34 . The cutaneous surface alterations that characterize cellulite are predominantly depressed when compared to cutaneous surface of the affected area 29 . These depressions have the same color and consistency as normal skin and the number of lesions may vary from one to many 29 . The shape of these lesions is varied 29 rounded oval or linear Fig. 3 . Most lesions are oval as the longest axis of the lesions lies parallel to the relaxed skin tension lines Figs. 4A-E . It is interesting to note that those lesions that do not have the same disposition in relation to the relaxed skin tension lines in general originate from secondary fibrosis of the subcutaneous tissue such as injections trauma etc. They are usually found in the lower portion of the buttocks and the upper thigh Fig. 4 . In both the buttocks and the upper thigh just below the gluteal fold the longest axis is in the horizontal direction with the lateral extremities slightly elevated. In these locations cellulite may be more evident due to flaccidity of the epidermis which tends to become aggravated with age. This can be demonstrated by the diminishing or even the disappearance of the lesions when the buttocks are lifted to their original position. CLASSIFICATION Several authors have .