Patients with acquired lipodystrophies

(A) Lipodystrophy in a male with HIV who received antiretroviral therapy containing a protease inhibitor for 6 years. Note the loss of fat from the face, arms, and legs; increased abdominal fat; and buffalo hump.

(B) Acquired partial lipodystrophy in a female with Barraquer-Simons syndrome. The loss of subcutaneous fat from the face, neck, arms, thorax, and upper abdomen began in adolescence. Note the excess subcutaneous fat in the legs.

(C) Acquired generalized lipodystrophy. The generalized loss of subcutaneous adipose tissue began in adolescence. Complications include severe insulin resistance, hyperinsulinemia, hypertriglyceridemia, and low serum high-density lipoprotein cholesterol concentrations.