Background: Abnormal distributions of body fat have been reported in association with HIV infection, including cases of both regional loss and gain of fat. Objective: We describe the spectrum of abnormal fat distribution in HIV-positive patients. Methods: Patients were included if they demonstrated a lack of subcutaneous fat in the cheeks in the absence of generalized wasting. Patients were examined fully and photographed, and medical records were reviewed. Results: Fourteen patients were seen. Further abnormalities of body fat distribution were noted in all patients. We found a consistent pattern of fat loss in the cheeks, temples, and extremities as well as fat gain over the neck, upper back, mastoid processes, chest, and visceral abdomen. Conclusion: A consistent syndrome of body fat redistribution is seen in HIV-positive patients. A characteristic pattern of fat loss in the cheeks may serve as a specific marker of HIV-related fat redistribution. (J Am Acad Dermatol 2000;42:727-30.)
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