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Data Trends 2025: Obesity

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References

1. GBD 2021 US Obesity Forecasting Collaborators. National-level and state-level prevalence of overweight and obesity among children, adolescents, and adults in the USA, 1990-2021, and forecasts up to 2050. Lancet. 2024;404(10469):2278-2298. doi:10.1016/S0140-6736(24)01548-4
2. Breland JY, et al. J Gen Intern Med. 2017;32(Suppl 1):11-17. doi:10.1007/s11606-016-3962-1
3. American Security Project. Costs and consequences: obesity’s compounding impact on the Military Health System. September 2024. Accessed April 21, 2025. https://www.americansecurityproject.org/wp-content/uploads/2024/09/Ref-0295-Costs-and-Consequences-Obesitys-Compounding-Impact-on-the-Military-Health-System.pdf
4. Baser O, et al. Healthcare (Basel). 2023;11(11):1529. doi:10.3390/healthcare11111529
5. Maclin-Akinyemi C, et al. Mil Med. 2017;182(9):e1816-e1823. doi:10.7205/MILMED-D-16-00380.
6. Yang D, et al. Mil Med. 2022;187(7-8):e948-e954. doi:10.1093/milmed/usab292
7. American Security Project. Ready the Reserve: obesity’s impacts on National Guard and Reserve readiness. April 2025. Accessed April 21, 2025. https://www.americansecurityproject.org/white-paper-ready-the-reserve-obesitys-impacts-onnational-guard-and-reserve-readiness/
8. Betancourt JA, et al. Healthcare (Basel). 2020;8(3):191. doi:10.3390/healthcare8030191
9. Breland JY, et al. Psychiatr Serv. 2020;1;71(5):506-509. doi:10.1176/appi.ps.201900078

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Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: American association of clinical endocrinologist; Endocrine fellow foundation; Intealth (ECFMG).

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Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: American association of clinical endocrinologist; Endocrine fellow foundation; Intealth (ECFMG).

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References

1. GBD 2021 US Obesity Forecasting Collaborators. National-level and state-level prevalence of overweight and obesity among children, adolescents, and adults in the USA, 1990-2021, and forecasts up to 2050. Lancet. 2024;404(10469):2278-2298. doi:10.1016/S0140-6736(24)01548-4
2. Breland JY, et al. J Gen Intern Med. 2017;32(Suppl 1):11-17. doi:10.1007/s11606-016-3962-1
3. American Security Project. Costs and consequences: obesity’s compounding impact on the Military Health System. September 2024. Accessed April 21, 2025. https://www.americansecurityproject.org/wp-content/uploads/2024/09/Ref-0295-Costs-and-Consequences-Obesitys-Compounding-Impact-on-the-Military-Health-System.pdf
4. Baser O, et al. Healthcare (Basel). 2023;11(11):1529. doi:10.3390/healthcare11111529
5. Maclin-Akinyemi C, et al. Mil Med. 2017;182(9):e1816-e1823. doi:10.7205/MILMED-D-16-00380.
6. Yang D, et al. Mil Med. 2022;187(7-8):e948-e954. doi:10.1093/milmed/usab292
7. American Security Project. Ready the Reserve: obesity’s impacts on National Guard and Reserve readiness. April 2025. Accessed April 21, 2025. https://www.americansecurityproject.org/white-paper-ready-the-reserve-obesitys-impacts-onnational-guard-and-reserve-readiness/
8. Betancourt JA, et al. Healthcare (Basel). 2020;8(3):191. doi:10.3390/healthcare8030191
9. Breland JY, et al. Psychiatr Serv. 2020;1;71(5):506-509. doi:10.1176/appi.ps.201900078

References

1. GBD 2021 US Obesity Forecasting Collaborators. National-level and state-level prevalence of overweight and obesity among children, adolescents, and adults in the USA, 1990-2021, and forecasts up to 2050. Lancet. 2024;404(10469):2278-2298. doi:10.1016/S0140-6736(24)01548-4
2. Breland JY, et al. J Gen Intern Med. 2017;32(Suppl 1):11-17. doi:10.1007/s11606-016-3962-1
3. American Security Project. Costs and consequences: obesity’s compounding impact on the Military Health System. September 2024. Accessed April 21, 2025. https://www.americansecurityproject.org/wp-content/uploads/2024/09/Ref-0295-Costs-and-Consequences-Obesitys-Compounding-Impact-on-the-Military-Health-System.pdf
4. Baser O, et al. Healthcare (Basel). 2023;11(11):1529. doi:10.3390/healthcare11111529
5. Maclin-Akinyemi C, et al. Mil Med. 2017;182(9):e1816-e1823. doi:10.7205/MILMED-D-16-00380.
6. Yang D, et al. Mil Med. 2022;187(7-8):e948-e954. doi:10.1093/milmed/usab292
7. American Security Project. Ready the Reserve: obesity’s impacts on National Guard and Reserve readiness. April 2025. Accessed April 21, 2025. https://www.americansecurityproject.org/white-paper-ready-the-reserve-obesitys-impacts-onnational-guard-and-reserve-readiness/
8. Betancourt JA, et al. Healthcare (Basel). 2020;8(3):191. doi:10.3390/healthcare8030191
9. Breland JY, et al. Psychiatr Serv. 2020;1;71(5):506-509. doi:10.1176/appi.ps.201900078

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In the United States, the prevalence of obesity substantially increased from 1990 to 2021 among both adults (+123.6% males; +99.9% females) and adolescents (+158.4% males; +185.9% females).1 Among veterans, obesity prevalence estimates vary from about one-quarter to one-half of the population across VHA facilities.2

Entry-level military roles are often recruited from lower-income groups that have higher occupational stress and mental health issues, and limited access to healthy food. Enlisted troops are 38% more likely to be diagnosed with obesity than their officer and civilian counterparts.3

Obesity is frequently underdiagnosed in veteran, active duty, and reserve populations, contributing to delayed treatment and increased risk for comorbidities.4 Obesity related conditions also contribute to higher health care utilization and costs for the Department of Defense and VHA.3

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Data Trends 2025: Hepatology

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Data Trends 2025: Hepatology

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References
  1. Niezen S, et al. Am J Gastroenterol. Published online January 7, 2025. doi:10.14309/ajg.0000000000003312
  2.  Beydoun HA, Tsai J. J Viral Hepat. 2024;31(10):601-613. doi:10.1111/jvh.13981
  3. Yeoh A, et al. J Clin Gastroenterol. 2024;58(7):718-725. doi:10.1097/MCG.0000000000001921
  4. Varley CD, et al. Clin Infect Dis. 2024;78(6):1571-1579. doi:10.1093/cid/ciae025
  5. Njei B, et al. Dig Dis Sci. 2025;70(2):802-813. doi:10.1007/s10620-024-08764-4
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References
  1. Niezen S, et al. Am J Gastroenterol. Published online January 7, 2025. doi:10.14309/ajg.0000000000003312
  2.  Beydoun HA, Tsai J. J Viral Hepat. 2024;31(10):601-613. doi:10.1111/jvh.13981
  3. Yeoh A, et al. J Clin Gastroenterol. 2024;58(7):718-725. doi:10.1097/MCG.0000000000001921
  4. Varley CD, et al. Clin Infect Dis. 2024;78(6):1571-1579. doi:10.1093/cid/ciae025
  5. Njei B, et al. Dig Dis Sci. 2025;70(2):802-813. doi:10.1007/s10620-024-08764-4
References
  1. Niezen S, et al. Am J Gastroenterol. Published online January 7, 2025. doi:10.14309/ajg.0000000000003312
  2.  Beydoun HA, Tsai J. J Viral Hepat. 2024;31(10):601-613. doi:10.1111/jvh.13981
  3. Yeoh A, et al. J Clin Gastroenterol. 2024;58(7):718-725. doi:10.1097/MCG.0000000000001921
  4. Varley CD, et al. Clin Infect Dis. 2024;78(6):1571-1579. doi:10.1093/cid/ciae025
  5. Njei B, et al. Dig Dis Sci. 2025;70(2):802-813. doi:10.1007/s10620-024-08764-4
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Data Trends 2025: Hepatology

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Screening rates in veterans are low for a variety of hepatologic diseases, such as metabolic dysfunction-associated steatotic liver disease (MASLD), hepatitis C virus (HCV), and hepatitis B virus (HBV).1,2 The veteran population has a high prevalence of metabolic and cardiovascular comorbidities, which are risk factors for MASLD.1,3 Veterans receiving VHA care also have a higher prevalence of HCV compared to the general US population.4 The VHA has achieved high HCV treatment and sustained virologic response (SVR) rates due to widespread use of direct-acting antivirals (DAAs).4 Within 5 years of diagnosis, about 2.5% of patients with MASLD progress to cirrhosis, with higher rates observed in certain races and ethnicities, as well as in those with elevated fibrosis-4 (FIB-4) index scores.3 HCV also increases risk of more advanced liver disease.4 Cirrhosis increases mortality risk in patients, particularly in those with MASLD and a BMI under 25.5 

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Federal Health Care Data Trends 2025

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Federal Health Care Data Trends is a special supplement to Federal Practitioner, showcasing the latest research in health care for veterans and active-duty military members via compelling infographics. 
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Federal Health Care Data Trends is a special supplement to Federal Practitioner, showcasing the latest research in health care for veterans and active-duty military members via compelling infographics. 
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Federal Health Care Data Trends is a special supplement to Federal Practitioner, showcasing the latest research in health care for veterans and active-duty military members via compelling infographics. 
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Data Trends 2025: LGBTQ+ Care

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References
  1. Meadows SO, et al. 2018 Department of Defense Health Related Behaviors Survey (HRBS): Sexual Orientation, Transgender, and Health Among US Active-Duty Service Members. RAND Corporation; 2018. Accessed May 13, 2025. https://www.rand.org/pubs/research_reports/RR4222.html
  2. Singh RS, et al. Front Public Health. 2024;11:1251565. doi:10.3389/fpubh.2023.1251565
  3. Livingston NA, et al. LGBT Health. 2022;9(2):136-144. doi:10.1089/lgbt.2021.0069
  4. Lamda, et al. LGBT Health. 2024;11(6). doi:10.1089/lgbt.2023.0224
  5. Shipherd JC, et al. LGBT Health. 2018;5(5):303-311. doi:10.1089/lgbt.2017.0179
  6. US Department of Veterans Affairs, Office of Health Equity. Health Disparities Among LGBT Veterans. Washington, DC: US Department of Veterans Affairs; Updated July 21, 2020. Accessed February 13, 2025. https://www.va.gov/HEALTHEQUITY/Health_Disparities_Among_LGBT_Veterans.asp
  7. McGirr J, et al. Chartbook on the Health of Lesbian, Gay, and Bisexual Veterans. Washington, DC: US Department of Veterans Affairs, Office of Health Equity, Veterans Health Administration; 2021. Accessed April 10, 2025. https://www.va.gov/HEALTHEQUITY/docs/LGB_Veteran_Health_Chartbook_Final.pdf

  8. Livingston NA. Trauma, minority stress, and disproportionate health burden among LGBTQ+ people. PTSD Research Quarterly. 2023;34(4):1050-1835. Accessed April10, 2025. https://www.ptsd.va.gov/publications/rq_docs/V34N4.pdf

     

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Aliya R. Webermann, PhD, Staff Psychologist, Department of Psychology Service, VA Connecticut Healthcare System, West Haven, Connecticut; Associate Research Scientist, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut. Aliya R. Webermann, PhD, has disclosed no relevant financial relationships.

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Aliya R. Webermann, PhD, Staff Psychologist, Department of Psychology Service, VA Connecticut Healthcare System, West Haven, Connecticut; Associate Research Scientist, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut. Aliya R. Webermann, PhD, has disclosed no relevant financial relationships.

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References
  1. Meadows SO, et al. 2018 Department of Defense Health Related Behaviors Survey (HRBS): Sexual Orientation, Transgender, and Health Among US Active-Duty Service Members. RAND Corporation; 2018. Accessed May 13, 2025. https://www.rand.org/pubs/research_reports/RR4222.html
  2. Singh RS, et al. Front Public Health. 2024;11:1251565. doi:10.3389/fpubh.2023.1251565
  3. Livingston NA, et al. LGBT Health. 2022;9(2):136-144. doi:10.1089/lgbt.2021.0069
  4. Lamda, et al. LGBT Health. 2024;11(6). doi:10.1089/lgbt.2023.0224
  5. Shipherd JC, et al. LGBT Health. 2018;5(5):303-311. doi:10.1089/lgbt.2017.0179
  6. US Department of Veterans Affairs, Office of Health Equity. Health Disparities Among LGBT Veterans. Washington, DC: US Department of Veterans Affairs; Updated July 21, 2020. Accessed February 13, 2025. https://www.va.gov/HEALTHEQUITY/Health_Disparities_Among_LGBT_Veterans.asp
  7. McGirr J, et al. Chartbook on the Health of Lesbian, Gay, and Bisexual Veterans. Washington, DC: US Department of Veterans Affairs, Office of Health Equity, Veterans Health Administration; 2021. Accessed April 10, 2025. https://www.va.gov/HEALTHEQUITY/docs/LGB_Veteran_Health_Chartbook_Final.pdf

  8. Livingston NA. Trauma, minority stress, and disproportionate health burden among LGBTQ+ people. PTSD Research Quarterly. 2023;34(4):1050-1835. Accessed April10, 2025. https://www.ptsd.va.gov/publications/rq_docs/V34N4.pdf

     

References
  1. Meadows SO, et al. 2018 Department of Defense Health Related Behaviors Survey (HRBS): Sexual Orientation, Transgender, and Health Among US Active-Duty Service Members. RAND Corporation; 2018. Accessed May 13, 2025. https://www.rand.org/pubs/research_reports/RR4222.html
  2. Singh RS, et al. Front Public Health. 2024;11:1251565. doi:10.3389/fpubh.2023.1251565
  3. Livingston NA, et al. LGBT Health. 2022;9(2):136-144. doi:10.1089/lgbt.2021.0069
  4. Lamda, et al. LGBT Health. 2024;11(6). doi:10.1089/lgbt.2023.0224
  5. Shipherd JC, et al. LGBT Health. 2018;5(5):303-311. doi:10.1089/lgbt.2017.0179
  6. US Department of Veterans Affairs, Office of Health Equity. Health Disparities Among LGBT Veterans. Washington, DC: US Department of Veterans Affairs; Updated July 21, 2020. Accessed February 13, 2025. https://www.va.gov/HEALTHEQUITY/Health_Disparities_Among_LGBT_Veterans.asp
  7. McGirr J, et al. Chartbook on the Health of Lesbian, Gay, and Bisexual Veterans. Washington, DC: US Department of Veterans Affairs, Office of Health Equity, Veterans Health Administration; 2021. Accessed April 10, 2025. https://www.va.gov/HEALTHEQUITY/docs/LGB_Veteran_Health_Chartbook_Final.pdf

  8. Livingston NA. Trauma, minority stress, and disproportionate health burden among LGBTQ+ people. PTSD Research Quarterly. 2023;34(4):1050-1835. Accessed April10, 2025. https://www.ptsd.va.gov/publications/rq_docs/V34N4.pdf

     

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In 2018, among 1.33 million active-duty service members, 6.3% (approximately 83,800) identified as LGBTQ+.1 LGBTQ+ service members and veterans report facing disparities, including discrimination, harassment, minority stress, and military sexual trauma.2 Studies have shown they are more likely to be diagnosed with PTSD and mood, anxiety, and substance use disorders.3 Within the VHA, LGBTQ+ veterans report barriers like lack of provider awareness, harassment, stigma, and negative reactions.2

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Data Trends 2025: HIV

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References
  1. Varley CD, et al. Clin Infect Dis. 2024;78(6):1571-1579. doi:10.1093/cid/
    ciae025

  2. Hicks WL, et al. HIV Med. 2025;26(2):218-229. doi:10.1111/hiv.13724

     

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Puja Van Epps, MD, Associate Professor, Department of Internal Medicine, Division of Infectious Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio; Special Assistant to Chief Officer, Specialty Care Program Office, Veterans Health Administration, Washington, DC. Puja Van Epps, MD, has disclosed the following relevant financial relationships: Received research grant from: ViiV Healthcare, ongoing - 2 year Investigator Initiated Study.

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References
  1. Varley CD, et al. Clin Infect Dis. 2024;78(6):1571-1579. doi:10.1093/cid/
    ciae025

  2. Hicks WL, et al. HIV Med. 2025;26(2):218-229. doi:10.1111/hiv.13724

     

References
  1. Varley CD, et al. Clin Infect Dis. 2024;78(6):1571-1579. doi:10.1093/cid/
    ciae025

  2. Hicks WL, et al. HIV Med. 2025;26(2):218-229. doi:10.1111/hiv.13724

     

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The VHA exceeds national benchmarks for human immunodeficiency virus (HIV) viral suppression rates, although suppression rates are lower than the VHA average among younger, female, Latino, and rural veterans.1 Cardiovascular health is an emerging concern for veterans with HIV, who experience higher mortality and severe events like stroke, despite fewer traditional risk factors.2

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Pedunculated Pink Papule on the Nose

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Emily Shaughnessy, MD
Michael J. Murphy, MD

THE DIAGNOSIS: Pedunculated Lipofibroma

Histopathology confirmed a pedunculated/polypoid lesion with intradermal lobules of adipocytes/mature adipose tissue admixed with connective tissue bundles and vascular ectasias. Overlying epidermal acanthosis with slight papillomatosis and hyperkeratosis was present (Figure 1). Masson trichrome staining highlighted admixed collagen bundles (Figure 2). Verhoeff–van Gieson staining showed marked reduction in elastic fibers (Figure 3). Immunostaining was negative for smooth muscle actin and desmin. A diagnosis of pedunculated lipofibroma on the nose was made based on both clinical and histopathologic findings.

CT116001008_e-Fig1_AB
FIGURE 1. A, Histopathology demonstrated a pedunculated/polypoid lesion with intradermal lobules of mature adipose tissue, admixed with connective tissue bundles and vascular ectasias (H&E, original magnification ×20). B, Overlying epidermal acanthosis with slight papillomatosis and hyperkeratosis was noted (H&E, original magnification ×100).
Beltrami-2
FIGURE 2. Admixed collagen bundles were highlighted (Masson Trichrome, original magnification ×100).
Beltrami-3
FIGURE 3. Marked reduction in elastic fibers was seen within the lesion, with adjacent background solar elastotic fibers on the right (Verhoeff-van Gieson, original magnification ×100).

Pedunculated lipofibroma (or solitary lipofibroma) is the solitary form of nevus lipomatosus cutaneous superficialis (NLCS).7 First described by Hoffmann and Zurhelle1 in 1921, NLCS is an uncommon benign hamartomatous cutaneous lesion/connective tissue nevus that also has a classic multiple form.1-13 The etiology of NLCS remains unclear, but several theories have been proposed to explain its pathogenesis, including deposition of adipocytes secondary to degenerative changes in dermal connective tissue, focal/local heterotopic development of adipose tissue, and derivation from differentiating lipoblasts (preadipose tissue) originating from precursor vascular or perivascular cells.2-13

Pedunculated lipofibroma usually develops during the third to sixth decades of life and manifests as a single cutaneous lesion with a smooth surface, often on a non–pelvic girdle location.7-13 No particular predilection sites are noted, with lesions reported on the arm, axilla, back, upper thigh, knee, and sole.5,12 There are rare reports of this type of NLCS on the ear, scalp, forehead, or eyelid.7-11

In the classic form of NLCS, multiple cutaneous lesions are present at birth or develop within the first 2 to 3 decades of life.2-6 Lesions consist of soft, nontender, pedunculated, flesh-colored or yellowish papules and nodules with a verrucoid or cerebriform surface that may later coalesce to form plaques.2-6 Predilection sites include the pelvic girdle, buttocks, sacral and coccygeal regions, and upper posterior thighs, with a linear or zosteriform pattern of distribution.2-6 Rarely, the classic form can arise in elderly patients and/or at an atypical anatomic location (eg, clitoris,3 shoulder,5 thorax,5 abdomen5) and can demonstrate extension of lesions across the midline.4 Rare cases of classic NLCS on the scalp2 and face3-6 have been reported, including lesions localized to the nose3 and chin4 and others extending from the right mandible to the neck5 and right lower lip to the submandibular/posteriorateral cervical region.6 In some cases, lesions clinically resemble plane xanthoma4 and localized scleroderma.6

Adotama et al13 proposed a set of clinical features to differentiate classic NLCS, pedunculated lipofibroma (solitary NLCS), and fibroepithelial polyp with adipocytes (distinguished by their furrowed surface, hyperpigmentation, and anatomic predilection for the neck and axilla). Lesions are asymptomatic in both forms of NLCS.2-13 Family history or predominant sex involvement have not been reported in either clinical type.2-13 Reported associations with NLCS include a number of endocrinologic conditions including diabetes.7 Other coexisting skin findings can include café-au-lait macules, leukodermic (white) spots, overlying hypertrichosis, comedolike alterations, angiokeratoma, hemangioma, and folliculosebaceous cystic hamartoma.4 None of these were evident in our patient.

Lesions from both types of NLCS are indistinguishable on histopathology, characterized by the presence of a central core of ectopic mature adipocytes in the papillary/reticular dermis.2-13 Additional light microscopic features (some seen in our case) have been described, including thickened collagen bundles, reduction of elastic fibers, increased numbers of fibroblasts and/or mast cells, increased (small-vessel) vascularity, focal mucin deposition/myxoid degeneration, a mild perivascular lymphocytic infiltrate, attenuation of adnexal structures, and abnormalities of the epidermis (eg, surface ulceration).2-13

Prior to biopsy, the differential diagnosis in our patient included angiofibroma, pyogenic granuloma, and basal cell carcinoma given the exophytic, pink, papular appearance of the lesion; however, the histopathologic differential diagnosis included angiofibroma, angiomyolipoma, lymphangioma, nevus sebaceus, and spindle cell lipoma (SCL). In angiofibroma, a dermal proliferation of stellate fibroblasts, dilated blood vessels, and collagenous stroma are seen. Cutaneous angiomyolipoma demonstrates smooth muscle bundles in addition to thickened blood vessels and variable proportions of mature adipocytes. Lymphangioma is characterized by dilated lymph channels lined by flat endothelial cells. Nevus sebaceus shows superficial immature and abnormally formed pilosebaceous units, with epidermal papillomatosis.

Rare cases of SCL on the nose have been described.14 Similar to pedunculated lipofibroma, reported examples demonstrate mature univacuolar adipocytes with thick collagen fibers and bland uniform spindle cells. Unlike the lesion seen in our patient, nasal SCL may be clinically mobile and typically is localized to the subcutaneous tissue, although dermal tumors also occur.14 Variably reported histopathologic findings in nasal SCL include circumscription/encapsulation, spindle cells arranged in short fascicles with nuclear palisading, a myxoid/mucinous interstitial matrix, and/or multinucleated giant cells—all light microscopic features that were not identified in our case; however, variable proportions of adipocytic, fibrous, and myxoid components among reported examples of SCL on the nose14 can make distinction from pedunculated lipofibroma difficult, as both are benign lipomatous tumor variants.

Clinically, pedunculated lipofibroma may be confused with more common benign cutaneous lesions and must be distinguished from other fibrolipomatous lesions on the nose. Specifically, the differential diagnosis includes benign cutaneous papillomas such as acrochordon, angiofibroma, melanocytic nevi, neurofibroma, nevus sebaceus, lymphangioma, and eccrine poroma.7-13 These all can be readily excluded on histopathology. Pedunculated lipofibroma on the nose, as in our patient, must be distinguished from fibrolipoma15 and dendritic myxofibrolipoma.16 Fibrolipoma is a subcutaneous proliferation of mature adipose tissue and fibrous tissue and comprises 1.6% of all facial lipomas reported worldwide.15 Dendritic myxofibrolipoma is a recently described benign soft-tissue tumor characterized by an admixture of mature adipose tissue, spindle and stellate cells, and an abundant myxoid stroma with prominent collagenization.16

Treatment of pedunculated lipofibroma on the nose is not indicated except for cosmetic reasons, in which case simple surgical excision would be considered satisfactory. Following biopsy, no further treatment was pursued in our patient.

References
  1. Hoffmann E, Zurhelle E. Uber einen naevus lipomatodes cutaneous superficialis der linken Glutaalgegend. Arch Derm Syph. 1921;130:327-333.
  2. Chanoki M, Isukos S, Suzuki S, et al. Nevus lipomatosus cutaneus superficialis of the scalp. Cutis. 1989;43:143-144.
  3. Sáez Rodríguez M, Rodríguez-Martin M, Carnerero A, et al. Naevus lipomatosus cutaneous superficialis on the nose. J Eur Acad Dermatol Venereol. 2005;19:751-752.
  4. Hassab-El-Naby HMM, Rageh MA. Adult-onset nevus lipomatosus cutaneous superficialis mimicking plane xanthoma. J Clin Aesthet Dermatol. 2022;15:10-11.
  5. Park HJ, Park CJ, Yi JY, et al. Nevus lipomatosus superficialis on the face. Int J Dermatol. 1997;36:435-437.
  6. Ioannidou DJ, Stefanidou MP, Panayiotides JG, et al. Nevus lipomatosus cutaneous superficialis (Hoffman-Zurhelle) with localized scleroderma like appearance. Int J Dermatol. 2001;40:54-57.
  7. Nogita T, Wong TY, Hidano A, et al. Pedunculated lipofibroma. a clinicopathologic study of thirty-two cases supporting a simplified nomenclature. J Am Acad Dermatol. 1994;31(2 pt 1):235-240.
  8. Sawada Y. Solitary nevus lipomatosus superficialis on the forehead. Ann Plast Surg. 1986;16:356-358.
  9. Knoth W. Uber Naevus lipomatosus cutaneus superficialis Hoffmann-Zurhelle und uber Naevus naevocellularis partim lipomatodes. Dermatologica. 1962;125:161.
  10. Weitzner S. Solitary naevus lipomatosus cutaneus superficialis of scalp. Arch Dermatol. 1968;97:540-542.
  11. Kaw P, Carlson A, Meyer DR. Nevus lipomatosus (pedunculated lipofibroma) of the eyelid. Ophthalmic Plast Reconstr Surg. 2005;21:74-76.
  12. Vano-Galvan S, Moreno C, Vano-Galvan E, et al. Solitary naevus lipomatosus cutaneous superficialis on the sole. Eur J Dermatol. 2008;18:353-354.
  13. Adotama P, Hutson SD, Rieder EA, et al. Revisiting solitary pedunculated lipofibromas. Am J Clin Pathol. 2021;156:954-957.
  14. Kubin ME, Lantto U, Lindgren O, et al. A rare, recurrent spindle cell lipoma of the nose. Acta Derm Venereol. 2021;101:adv00571.
  15. Jung SN, Shin JW, Kwon H, et al. Fibrolipoma of the tip of the nose. J Craniofac Surg. 2009;20:555-556.
  16. Han XC, Zheng LQ, Shang XL. Dendritic fibromyxolipoma on the nasal tip in an old patient. Int J Clin Exp Pathol. 2014;7:7064-7067.
Article PDF
CT116001008_e.pdf
Author and Disclosure Information

Dr. Beltrami is from the University of Connecticut School of Medicine, Farmington. Dr. Shaughnessy is from the Department of Dermatology, Hartford Hospital, Connecticut. Dr. Murphy is from the Department of Dermatology, UConn Health, Farmington.

The authors have no relevant financial disclosure to report.

Correspondence: Michael J. Murphy, MD, Department of Dermatology, UConn Health, 21 South Rd, 1st Floor, Farmington, CT 06032 ([email protected]).

Cutis. 2025 July;116(1):E8-E11. doi:10.12788/cutis.1252

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Eric J. Beltrami, BS
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Michael J. Murphy, MD
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Emily Shaughnessy, MD
Michael J. Murphy, MD
Author and Disclosure Information

Dr. Beltrami is from the University of Connecticut School of Medicine, Farmington. Dr. Shaughnessy is from the Department of Dermatology, Hartford Hospital, Connecticut. Dr. Murphy is from the Department of Dermatology, UConn Health, Farmington.

The authors have no relevant financial disclosure to report.

Correspondence: Michael J. Murphy, MD, Department of Dermatology, UConn Health, 21 South Rd, 1st Floor, Farmington, CT 06032 ([email protected]).

Cutis. 2025 July;116(1):E8-E11. doi:10.12788/cutis.1252

Author and Disclosure Information

Dr. Beltrami is from the University of Connecticut School of Medicine, Farmington. Dr. Shaughnessy is from the Department of Dermatology, Hartford Hospital, Connecticut. Dr. Murphy is from the Department of Dermatology, UConn Health, Farmington.

The authors have no relevant financial disclosure to report.

Correspondence: Michael J. Murphy, MD, Department of Dermatology, UConn Health, 21 South Rd, 1st Floor, Farmington, CT 06032 ([email protected]).

Cutis. 2025 July;116(1):E8-E11. doi:10.12788/cutis.1252

Article PDF
CT116001008_e.pdf
Article PDF
CT116001008_e.pdf

THE DIAGNOSIS: Pedunculated Lipofibroma

Histopathology confirmed a pedunculated/polypoid lesion with intradermal lobules of adipocytes/mature adipose tissue admixed with connective tissue bundles and vascular ectasias. Overlying epidermal acanthosis with slight papillomatosis and hyperkeratosis was present (Figure 1). Masson trichrome staining highlighted admixed collagen bundles (Figure 2). Verhoeff–van Gieson staining showed marked reduction in elastic fibers (Figure 3). Immunostaining was negative for smooth muscle actin and desmin. A diagnosis of pedunculated lipofibroma on the nose was made based on both clinical and histopathologic findings.

CT116001008_e-Fig1_AB
FIGURE 1. A, Histopathology demonstrated a pedunculated/polypoid lesion with intradermal lobules of mature adipose tissue, admixed with connective tissue bundles and vascular ectasias (H&E, original magnification ×20). B, Overlying epidermal acanthosis with slight papillomatosis and hyperkeratosis was noted (H&E, original magnification ×100).
Beltrami-2
FIGURE 2. Admixed collagen bundles were highlighted (Masson Trichrome, original magnification ×100).
Beltrami-3
FIGURE 3. Marked reduction in elastic fibers was seen within the lesion, with adjacent background solar elastotic fibers on the right (Verhoeff-van Gieson, original magnification ×100).

Pedunculated lipofibroma (or solitary lipofibroma) is the solitary form of nevus lipomatosus cutaneous superficialis (NLCS).7 First described by Hoffmann and Zurhelle1 in 1921, NLCS is an uncommon benign hamartomatous cutaneous lesion/connective tissue nevus that also has a classic multiple form.1-13 The etiology of NLCS remains unclear, but several theories have been proposed to explain its pathogenesis, including deposition of adipocytes secondary to degenerative changes in dermal connective tissue, focal/local heterotopic development of adipose tissue, and derivation from differentiating lipoblasts (preadipose tissue) originating from precursor vascular or perivascular cells.2-13

Pedunculated lipofibroma usually develops during the third to sixth decades of life and manifests as a single cutaneous lesion with a smooth surface, often on a non–pelvic girdle location.7-13 No particular predilection sites are noted, with lesions reported on the arm, axilla, back, upper thigh, knee, and sole.5,12 There are rare reports of this type of NLCS on the ear, scalp, forehead, or eyelid.7-11

In the classic form of NLCS, multiple cutaneous lesions are present at birth or develop within the first 2 to 3 decades of life.2-6 Lesions consist of soft, nontender, pedunculated, flesh-colored or yellowish papules and nodules with a verrucoid or cerebriform surface that may later coalesce to form plaques.2-6 Predilection sites include the pelvic girdle, buttocks, sacral and coccygeal regions, and upper posterior thighs, with a linear or zosteriform pattern of distribution.2-6 Rarely, the classic form can arise in elderly patients and/or at an atypical anatomic location (eg, clitoris,3 shoulder,5 thorax,5 abdomen5) and can demonstrate extension of lesions across the midline.4 Rare cases of classic NLCS on the scalp2 and face3-6 have been reported, including lesions localized to the nose3 and chin4 and others extending from the right mandible to the neck5 and right lower lip to the submandibular/posteriorateral cervical region.6 In some cases, lesions clinically resemble plane xanthoma4 and localized scleroderma.6

Adotama et al13 proposed a set of clinical features to differentiate classic NLCS, pedunculated lipofibroma (solitary NLCS), and fibroepithelial polyp with adipocytes (distinguished by their furrowed surface, hyperpigmentation, and anatomic predilection for the neck and axilla). Lesions are asymptomatic in both forms of NLCS.2-13 Family history or predominant sex involvement have not been reported in either clinical type.2-13 Reported associations with NLCS include a number of endocrinologic conditions including diabetes.7 Other coexisting skin findings can include café-au-lait macules, leukodermic (white) spots, overlying hypertrichosis, comedolike alterations, angiokeratoma, hemangioma, and folliculosebaceous cystic hamartoma.4 None of these were evident in our patient.

Lesions from both types of NLCS are indistinguishable on histopathology, characterized by the presence of a central core of ectopic mature adipocytes in the papillary/reticular dermis.2-13 Additional light microscopic features (some seen in our case) have been described, including thickened collagen bundles, reduction of elastic fibers, increased numbers of fibroblasts and/or mast cells, increased (small-vessel) vascularity, focal mucin deposition/myxoid degeneration, a mild perivascular lymphocytic infiltrate, attenuation of adnexal structures, and abnormalities of the epidermis (eg, surface ulceration).2-13

Prior to biopsy, the differential diagnosis in our patient included angiofibroma, pyogenic granuloma, and basal cell carcinoma given the exophytic, pink, papular appearance of the lesion; however, the histopathologic differential diagnosis included angiofibroma, angiomyolipoma, lymphangioma, nevus sebaceus, and spindle cell lipoma (SCL). In angiofibroma, a dermal proliferation of stellate fibroblasts, dilated blood vessels, and collagenous stroma are seen. Cutaneous angiomyolipoma demonstrates smooth muscle bundles in addition to thickened blood vessels and variable proportions of mature adipocytes. Lymphangioma is characterized by dilated lymph channels lined by flat endothelial cells. Nevus sebaceus shows superficial immature and abnormally formed pilosebaceous units, with epidermal papillomatosis.

Rare cases of SCL on the nose have been described.14 Similar to pedunculated lipofibroma, reported examples demonstrate mature univacuolar adipocytes with thick collagen fibers and bland uniform spindle cells. Unlike the lesion seen in our patient, nasal SCL may be clinically mobile and typically is localized to the subcutaneous tissue, although dermal tumors also occur.14 Variably reported histopathologic findings in nasal SCL include circumscription/encapsulation, spindle cells arranged in short fascicles with nuclear palisading, a myxoid/mucinous interstitial matrix, and/or multinucleated giant cells—all light microscopic features that were not identified in our case; however, variable proportions of adipocytic, fibrous, and myxoid components among reported examples of SCL on the nose14 can make distinction from pedunculated lipofibroma difficult, as both are benign lipomatous tumor variants.

Clinically, pedunculated lipofibroma may be confused with more common benign cutaneous lesions and must be distinguished from other fibrolipomatous lesions on the nose. Specifically, the differential diagnosis includes benign cutaneous papillomas such as acrochordon, angiofibroma, melanocytic nevi, neurofibroma, nevus sebaceus, lymphangioma, and eccrine poroma.7-13 These all can be readily excluded on histopathology. Pedunculated lipofibroma on the nose, as in our patient, must be distinguished from fibrolipoma15 and dendritic myxofibrolipoma.16 Fibrolipoma is a subcutaneous proliferation of mature adipose tissue and fibrous tissue and comprises 1.6% of all facial lipomas reported worldwide.15 Dendritic myxofibrolipoma is a recently described benign soft-tissue tumor characterized by an admixture of mature adipose tissue, spindle and stellate cells, and an abundant myxoid stroma with prominent collagenization.16

Treatment of pedunculated lipofibroma on the nose is not indicated except for cosmetic reasons, in which case simple surgical excision would be considered satisfactory. Following biopsy, no further treatment was pursued in our patient.

THE DIAGNOSIS: Pedunculated Lipofibroma

Histopathology confirmed a pedunculated/polypoid lesion with intradermal lobules of adipocytes/mature adipose tissue admixed with connective tissue bundles and vascular ectasias. Overlying epidermal acanthosis with slight papillomatosis and hyperkeratosis was present (Figure 1). Masson trichrome staining highlighted admixed collagen bundles (Figure 2). Verhoeff–van Gieson staining showed marked reduction in elastic fibers (Figure 3). Immunostaining was negative for smooth muscle actin and desmin. A diagnosis of pedunculated lipofibroma on the nose was made based on both clinical and histopathologic findings.

CT116001008_e-Fig1_AB
FIGURE 1. A, Histopathology demonstrated a pedunculated/polypoid lesion with intradermal lobules of mature adipose tissue, admixed with connective tissue bundles and vascular ectasias (H&E, original magnification ×20). B, Overlying epidermal acanthosis with slight papillomatosis and hyperkeratosis was noted (H&E, original magnification ×100).
Beltrami-2
FIGURE 2. Admixed collagen bundles were highlighted (Masson Trichrome, original magnification ×100).
Beltrami-3
FIGURE 3. Marked reduction in elastic fibers was seen within the lesion, with adjacent background solar elastotic fibers on the right (Verhoeff-van Gieson, original magnification ×100).

Pedunculated lipofibroma (or solitary lipofibroma) is the solitary form of nevus lipomatosus cutaneous superficialis (NLCS).7 First described by Hoffmann and Zurhelle1 in 1921, NLCS is an uncommon benign hamartomatous cutaneous lesion/connective tissue nevus that also has a classic multiple form.1-13 The etiology of NLCS remains unclear, but several theories have been proposed to explain its pathogenesis, including deposition of adipocytes secondary to degenerative changes in dermal connective tissue, focal/local heterotopic development of adipose tissue, and derivation from differentiating lipoblasts (preadipose tissue) originating from precursor vascular or perivascular cells.2-13

Pedunculated lipofibroma usually develops during the third to sixth decades of life and manifests as a single cutaneous lesion with a smooth surface, often on a non–pelvic girdle location.7-13 No particular predilection sites are noted, with lesions reported on the arm, axilla, back, upper thigh, knee, and sole.5,12 There are rare reports of this type of NLCS on the ear, scalp, forehead, or eyelid.7-11

In the classic form of NLCS, multiple cutaneous lesions are present at birth or develop within the first 2 to 3 decades of life.2-6 Lesions consist of soft, nontender, pedunculated, flesh-colored or yellowish papules and nodules with a verrucoid or cerebriform surface that may later coalesce to form plaques.2-6 Predilection sites include the pelvic girdle, buttocks, sacral and coccygeal regions, and upper posterior thighs, with a linear or zosteriform pattern of distribution.2-6 Rarely, the classic form can arise in elderly patients and/or at an atypical anatomic location (eg, clitoris,3 shoulder,5 thorax,5 abdomen5) and can demonstrate extension of lesions across the midline.4 Rare cases of classic NLCS on the scalp2 and face3-6 have been reported, including lesions localized to the nose3 and chin4 and others extending from the right mandible to the neck5 and right lower lip to the submandibular/posteriorateral cervical region.6 In some cases, lesions clinically resemble plane xanthoma4 and localized scleroderma.6

Adotama et al13 proposed a set of clinical features to differentiate classic NLCS, pedunculated lipofibroma (solitary NLCS), and fibroepithelial polyp with adipocytes (distinguished by their furrowed surface, hyperpigmentation, and anatomic predilection for the neck and axilla). Lesions are asymptomatic in both forms of NLCS.2-13 Family history or predominant sex involvement have not been reported in either clinical type.2-13 Reported associations with NLCS include a number of endocrinologic conditions including diabetes.7 Other coexisting skin findings can include café-au-lait macules, leukodermic (white) spots, overlying hypertrichosis, comedolike alterations, angiokeratoma, hemangioma, and folliculosebaceous cystic hamartoma.4 None of these were evident in our patient.

Lesions from both types of NLCS are indistinguishable on histopathology, characterized by the presence of a central core of ectopic mature adipocytes in the papillary/reticular dermis.2-13 Additional light microscopic features (some seen in our case) have been described, including thickened collagen bundles, reduction of elastic fibers, increased numbers of fibroblasts and/or mast cells, increased (small-vessel) vascularity, focal mucin deposition/myxoid degeneration, a mild perivascular lymphocytic infiltrate, attenuation of adnexal structures, and abnormalities of the epidermis (eg, surface ulceration).2-13

Prior to biopsy, the differential diagnosis in our patient included angiofibroma, pyogenic granuloma, and basal cell carcinoma given the exophytic, pink, papular appearance of the lesion; however, the histopathologic differential diagnosis included angiofibroma, angiomyolipoma, lymphangioma, nevus sebaceus, and spindle cell lipoma (SCL). In angiofibroma, a dermal proliferation of stellate fibroblasts, dilated blood vessels, and collagenous stroma are seen. Cutaneous angiomyolipoma demonstrates smooth muscle bundles in addition to thickened blood vessels and variable proportions of mature adipocytes. Lymphangioma is characterized by dilated lymph channels lined by flat endothelial cells. Nevus sebaceus shows superficial immature and abnormally formed pilosebaceous units, with epidermal papillomatosis.

Rare cases of SCL on the nose have been described.14 Similar to pedunculated lipofibroma, reported examples demonstrate mature univacuolar adipocytes with thick collagen fibers and bland uniform spindle cells. Unlike the lesion seen in our patient, nasal SCL may be clinically mobile and typically is localized to the subcutaneous tissue, although dermal tumors also occur.14 Variably reported histopathologic findings in nasal SCL include circumscription/encapsulation, spindle cells arranged in short fascicles with nuclear palisading, a myxoid/mucinous interstitial matrix, and/or multinucleated giant cells—all light microscopic features that were not identified in our case; however, variable proportions of adipocytic, fibrous, and myxoid components among reported examples of SCL on the nose14 can make distinction from pedunculated lipofibroma difficult, as both are benign lipomatous tumor variants.

Clinically, pedunculated lipofibroma may be confused with more common benign cutaneous lesions and must be distinguished from other fibrolipomatous lesions on the nose. Specifically, the differential diagnosis includes benign cutaneous papillomas such as acrochordon, angiofibroma, melanocytic nevi, neurofibroma, nevus sebaceus, lymphangioma, and eccrine poroma.7-13 These all can be readily excluded on histopathology. Pedunculated lipofibroma on the nose, as in our patient, must be distinguished from fibrolipoma15 and dendritic myxofibrolipoma.16 Fibrolipoma is a subcutaneous proliferation of mature adipose tissue and fibrous tissue and comprises 1.6% of all facial lipomas reported worldwide.15 Dendritic myxofibrolipoma is a recently described benign soft-tissue tumor characterized by an admixture of mature adipose tissue, spindle and stellate cells, and an abundant myxoid stroma with prominent collagenization.16

Treatment of pedunculated lipofibroma on the nose is not indicated except for cosmetic reasons, in which case simple surgical excision would be considered satisfactory. Following biopsy, no further treatment was pursued in our patient.

References
  1. Hoffmann E, Zurhelle E. Uber einen naevus lipomatodes cutaneous superficialis der linken Glutaalgegend. Arch Derm Syph. 1921;130:327-333.
  2. Chanoki M, Isukos S, Suzuki S, et al. Nevus lipomatosus cutaneus superficialis of the scalp. Cutis. 1989;43:143-144.
  3. Sáez Rodríguez M, Rodríguez-Martin M, Carnerero A, et al. Naevus lipomatosus cutaneous superficialis on the nose. J Eur Acad Dermatol Venereol. 2005;19:751-752.
  4. Hassab-El-Naby HMM, Rageh MA. Adult-onset nevus lipomatosus cutaneous superficialis mimicking plane xanthoma. J Clin Aesthet Dermatol. 2022;15:10-11.
  5. Park HJ, Park CJ, Yi JY, et al. Nevus lipomatosus superficialis on the face. Int J Dermatol. 1997;36:435-437.
  6. Ioannidou DJ, Stefanidou MP, Panayiotides JG, et al. Nevus lipomatosus cutaneous superficialis (Hoffman-Zurhelle) with localized scleroderma like appearance. Int J Dermatol. 2001;40:54-57.
  7. Nogita T, Wong TY, Hidano A, et al. Pedunculated lipofibroma. a clinicopathologic study of thirty-two cases supporting a simplified nomenclature. J Am Acad Dermatol. 1994;31(2 pt 1):235-240.
  8. Sawada Y. Solitary nevus lipomatosus superficialis on the forehead. Ann Plast Surg. 1986;16:356-358.
  9. Knoth W. Uber Naevus lipomatosus cutaneus superficialis Hoffmann-Zurhelle und uber Naevus naevocellularis partim lipomatodes. Dermatologica. 1962;125:161.
  10. Weitzner S. Solitary naevus lipomatosus cutaneus superficialis of scalp. Arch Dermatol. 1968;97:540-542.
  11. Kaw P, Carlson A, Meyer DR. Nevus lipomatosus (pedunculated lipofibroma) of the eyelid. Ophthalmic Plast Reconstr Surg. 2005;21:74-76.
  12. Vano-Galvan S, Moreno C, Vano-Galvan E, et al. Solitary naevus lipomatosus cutaneous superficialis on the sole. Eur J Dermatol. 2008;18:353-354.
  13. Adotama P, Hutson SD, Rieder EA, et al. Revisiting solitary pedunculated lipofibromas. Am J Clin Pathol. 2021;156:954-957.
  14. Kubin ME, Lantto U, Lindgren O, et al. A rare, recurrent spindle cell lipoma of the nose. Acta Derm Venereol. 2021;101:adv00571.
  15. Jung SN, Shin JW, Kwon H, et al. Fibrolipoma of the tip of the nose. J Craniofac Surg. 2009;20:555-556.
  16. Han XC, Zheng LQ, Shang XL. Dendritic fibromyxolipoma on the nasal tip in an old patient. Int J Clin Exp Pathol. 2014;7:7064-7067.
References
  1. Hoffmann E, Zurhelle E. Uber einen naevus lipomatodes cutaneous superficialis der linken Glutaalgegend. Arch Derm Syph. 1921;130:327-333.
  2. Chanoki M, Isukos S, Suzuki S, et al. Nevus lipomatosus cutaneus superficialis of the scalp. Cutis. 1989;43:143-144.
  3. Sáez Rodríguez M, Rodríguez-Martin M, Carnerero A, et al. Naevus lipomatosus cutaneous superficialis on the nose. J Eur Acad Dermatol Venereol. 2005;19:751-752.
  4. Hassab-El-Naby HMM, Rageh MA. Adult-onset nevus lipomatosus cutaneous superficialis mimicking plane xanthoma. J Clin Aesthet Dermatol. 2022;15:10-11.
  5. Park HJ, Park CJ, Yi JY, et al. Nevus lipomatosus superficialis on the face. Int J Dermatol. 1997;36:435-437.
  6. Ioannidou DJ, Stefanidou MP, Panayiotides JG, et al. Nevus lipomatosus cutaneous superficialis (Hoffman-Zurhelle) with localized scleroderma like appearance. Int J Dermatol. 2001;40:54-57.
  7. Nogita T, Wong TY, Hidano A, et al. Pedunculated lipofibroma. a clinicopathologic study of thirty-two cases supporting a simplified nomenclature. J Am Acad Dermatol. 1994;31(2 pt 1):235-240.
  8. Sawada Y. Solitary nevus lipomatosus superficialis on the forehead. Ann Plast Surg. 1986;16:356-358.
  9. Knoth W. Uber Naevus lipomatosus cutaneus superficialis Hoffmann-Zurhelle und uber Naevus naevocellularis partim lipomatodes. Dermatologica. 1962;125:161.
  10. Weitzner S. Solitary naevus lipomatosus cutaneus superficialis of scalp. Arch Dermatol. 1968;97:540-542.
  11. Kaw P, Carlson A, Meyer DR. Nevus lipomatosus (pedunculated lipofibroma) of the eyelid. Ophthalmic Plast Reconstr Surg. 2005;21:74-76.
  12. Vano-Galvan S, Moreno C, Vano-Galvan E, et al. Solitary naevus lipomatosus cutaneous superficialis on the sole. Eur J Dermatol. 2008;18:353-354.
  13. Adotama P, Hutson SD, Rieder EA, et al. Revisiting solitary pedunculated lipofibromas. Am J Clin Pathol. 2021;156:954-957.
  14. Kubin ME, Lantto U, Lindgren O, et al. A rare, recurrent spindle cell lipoma of the nose. Acta Derm Venereol. 2021;101:adv00571.
  15. Jung SN, Shin JW, Kwon H, et al. Fibrolipoma of the tip of the nose. J Craniofac Surg. 2009;20:555-556.
  16. Han XC, Zheng LQ, Shang XL. Dendritic fibromyxolipoma on the nasal tip in an old patient. Int J Clin Exp Pathol. 2014;7:7064-7067.
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A 60-year-old woman presented to the dermatology department with a 6-mm, firm, pink, nonulcerated, nonmobile papule on the right nasal side wall of 1 year’s duration. It had grown slowly and was asymptomatic with no tenderness or bleeding. No other skin lesions were noted on physical examination, and her medical history was otherwise unremarkable. A shave biopsy was performed.

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References
  1. Rezaei SJ, et al. JAMA Dermatol. 2024;160(10):1107-1111. doi:10.1001/jamadermatol. 2024.3043 
  2. Singal A, Lipner SR. Ann Med. 2023;55(2):2267425. doi:10.1080/07853890.2023.2267425 
  3. Reese R, et al. J Dermatolog Treat. 2024;35(1):2402912. doi:10.1080/09546634.2024.2402912 
  4. Wallace MM, et al. Telemed J E Health. 2024;30(5):1411-1417. doi:10.1089/tmj.2022.0528 
  5. Russell A, et al. Mil Med. 2024;189(11-12):e2374-e2381. doi:10.1093/milmed/usae139 

  6. Salahuddin T, et al. J Eur Acad Dermatol Venereol. 2023;37(7):e862-e864. doi:10.1111/jdv.18964 

     

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Brett Sloan, MD, Professor of Dermatology, University of Connecticut School of Medicine; Residency Program Director, Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut. Brett Sloan, MD, has disclosed the following relevant financial relationships: Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: University of Connecticut; Department of Veterans Affairs Received income in an amount equal to or greater than $250 from: University of Connecticut; Department of Veterans Affairs.

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Brett Sloan, MD, Professor of Dermatology, University of Connecticut School of Medicine; Residency Program Director, Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut. Brett Sloan, MD, has disclosed the following relevant financial relationships: Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: University of Connecticut; Department of Veterans Affairs Received income in an amount equal to or greater than $250 from: University of Connecticut; Department of Veterans Affairs.

Click here to view more from Federal Health Care Data Trends 2025.

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References
  1. Rezaei SJ, et al. JAMA Dermatol. 2024;160(10):1107-1111. doi:10.1001/jamadermatol. 2024.3043 
  2. Singal A, Lipner SR. Ann Med. 2023;55(2):2267425. doi:10.1080/07853890.2023.2267425 
  3. Reese R, et al. J Dermatolog Treat. 2024;35(1):2402912. doi:10.1080/09546634.2024.2402912 
  4. Wallace MM, et al. Telemed J E Health. 2024;30(5):1411-1417. doi:10.1089/tmj.2022.0528 
  5. Russell A, et al. Mil Med. 2024;189(11-12):e2374-e2381. doi:10.1093/milmed/usae139 

  6. Salahuddin T, et al. J Eur Acad Dermatol Venereol. 2023;37(7):e862-e864. doi:10.1111/jdv.18964 

     

References
  1. Rezaei SJ, et al. JAMA Dermatol. 2024;160(10):1107-1111. doi:10.1001/jamadermatol. 2024.3043 
  2. Singal A, Lipner SR. Ann Med. 2023;55(2):2267425. doi:10.1080/07853890.2023.2267425 
  3. Reese R, et al. J Dermatolog Treat. 2024;35(1):2402912. doi:10.1080/09546634.2024.2402912 
  4. Wallace MM, et al. Telemed J E Health. 2024;30(5):1411-1417. doi:10.1089/tmj.2022.0528 
  5. Russell A, et al. Mil Med. 2024;189(11-12):e2374-e2381. doi:10.1093/milmed/usae139 

  6. Salahuddin T, et al. J Eur Acad Dermatol Venereol. 2023;37(7):e862-e864. doi:10.1111/jdv.18964 

     

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Service members experience unique risk factors for dermatologic conditions, such as increased sun exposure, crowded living conditions, environmental contaminants, skin injury, and extreme temperatures.1,2 Veterans have an estimated 72% higher risk for any skin cancer compared to civilians, and are also at an increased risk of psoriasis, a chronic immune-mediated skin condition.1,3 Dermatitis and eczema are also common conditions in military personnel, accounting for 17.0%-38.7% of skin diagnoses during military missions in Lebanon, Iraq, and Sudan.2

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References
  1. Lin C, et al. Front Neurol. 2024;15:1392721. Published 2024 Mar 12. doi:10.3389/fneur.2024.1392721
  2. Defense Medical Surveillance System, Theater Medical Data Store provided by the Armed Forces Health Surveillance Division. Prepared by the Traumatic Brain Injury Center of Excellence. Accessed April 2, 2025. https://health.mil/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/DODTBI-Worldwide-Numbers
  3. Karr JE, et al. Arch Phys Med Rehabil. 2025;106(4):537-547. doi:10.1016/j.apmr.2024.11.010
  4. Howard JT, et al. J Racial Ethn Health Disparities. 2025;12(3):1745-1756. doi:10.1007/s40615-024-02004-1
  5. Gasperi M, et al. JAMA Netw Open. 2024;7(3):e242299. doi:10.1001/jamanetworkopen.2024.2299
  6. Roghani A, et al. Epilepsia. 2024;65(8):2255-2269. doi:10.1111/epi.18026
  7. Herbert MS, et al. Headache. 2025;65(3):430-438. doi:10.1111/head.14815
  8. Fleming NH, et al. Mult Scler Relat Disord. 2024;82:105372. doi:10.1016/j.msard.2023.105372
  9. Silveira SL, et al. CNS Spectr. 2024;29(6):1-8. doi:10.1017/S1092852924002165
  10. Whiteneck G, et al. J Head Trauma Rehabil. 2024;39(5):E462-E469. doi:10.1097/HTR.0000000000000952

  11. Seng EK, et al. Headache. 2024;64(10):1273-1284. doi:10.1111/head.14842

     

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References
  1. Lin C, et al. Front Neurol. 2024;15:1392721. Published 2024 Mar 12. doi:10.3389/fneur.2024.1392721
  2. Defense Medical Surveillance System, Theater Medical Data Store provided by the Armed Forces Health Surveillance Division. Prepared by the Traumatic Brain Injury Center of Excellence. Accessed April 2, 2025. https://health.mil/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/DODTBI-Worldwide-Numbers
  3. Karr JE, et al. Arch Phys Med Rehabil. 2025;106(4):537-547. doi:10.1016/j.apmr.2024.11.010
  4. Howard JT, et al. J Racial Ethn Health Disparities. 2025;12(3):1745-1756. doi:10.1007/s40615-024-02004-1
  5. Gasperi M, et al. JAMA Netw Open. 2024;7(3):e242299. doi:10.1001/jamanetworkopen.2024.2299
  6. Roghani A, et al. Epilepsia. 2024;65(8):2255-2269. doi:10.1111/epi.18026
  7. Herbert MS, et al. Headache. 2025;65(3):430-438. doi:10.1111/head.14815
  8. Fleming NH, et al. Mult Scler Relat Disord. 2024;82:105372. doi:10.1016/j.msard.2023.105372
  9. Silveira SL, et al. CNS Spectr. 2024;29(6):1-8. doi:10.1017/S1092852924002165
  10. Whiteneck G, et al. J Head Trauma Rehabil. 2024;39(5):E462-E469. doi:10.1097/HTR.0000000000000952

  11. Seng EK, et al. Headache. 2024;64(10):1273-1284. doi:10.1111/head.14842

     

References
  1. Lin C, et al. Front Neurol. 2024;15:1392721. Published 2024 Mar 12. doi:10.3389/fneur.2024.1392721
  2. Defense Medical Surveillance System, Theater Medical Data Store provided by the Armed Forces Health Surveillance Division. Prepared by the Traumatic Brain Injury Center of Excellence. Accessed April 2, 2025. https://health.mil/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/DODTBI-Worldwide-Numbers
  3. Karr JE, et al. Arch Phys Med Rehabil. 2025;106(4):537-547. doi:10.1016/j.apmr.2024.11.010
  4. Howard JT, et al. J Racial Ethn Health Disparities. 2025;12(3):1745-1756. doi:10.1007/s40615-024-02004-1
  5. Gasperi M, et al. JAMA Netw Open. 2024;7(3):e242299. doi:10.1001/jamanetworkopen.2024.2299
  6. Roghani A, et al. Epilepsia. 2024;65(8):2255-2269. doi:10.1111/epi.18026
  7. Herbert MS, et al. Headache. 2025;65(3):430-438. doi:10.1111/head.14815
  8. Fleming NH, et al. Mult Scler Relat Disord. 2024;82:105372. doi:10.1016/j.msard.2023.105372
  9. Silveira SL, et al. CNS Spectr. 2024;29(6):1-8. doi:10.1017/S1092852924002165
  10. Whiteneck G, et al. J Head Trauma Rehabil. 2024;39(5):E462-E469. doi:10.1097/HTR.0000000000000952

  11. Seng EK, et al. Headache. 2024;64(10):1273-1284. doi:10.1111/head.14842

     

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Active-duty military personnel and veterans experience unique neurologic morbidity compared to the general population.1 Over 500,000 service members have been diagnosed with TBI from 2000-2024.2 Many of these veterans have mental and physical health comorbidities, and up to 84% higher risk of all-cause mortality.3,4 TBI is associated with other neurological conditions, such as posttraumatic headaches, migraines, and epilepsy.5,6 In a large cohort study, migraine prevalence was found to be approximately 10%, with prevalence as high as 30% in women veterans.5 Migraine and TBI co-occur in 2.3% of veterans, exacerbating cognitive dysfunction more than either condition alone.7 Veterans with multiple sclerosis (MS) face higher risks of dementia, depression, and cannabis use disorder, with mental health risks being amplified by younger age, minority status, combat exposure, and disability.8,9

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References
  1. Women Veterans Health Care: Facts and Statistics. US Department of Veterans Affairs. Published 2022. Accessed May 23, 2025. https://www.womenshealth.va.gov/materials-and-resources/facts-and-statistics.asp
  2. Sourcebook: Women Veterans in the Veterans Health Administration. Volume 5: Longitudinal Trends in Sociodemographics and Utilization, Including Type, Modality, and Source of Care. US Department of Veterans Affairs; 2024. Accessed May 23, 2025. https://www.womenshealth.va.gov/WOMENSHEALTH/docs/VHA-Source-book-V5-FINAL.pdf
  3. Goldstein KM, et al. JAMA Netw Open. 2025;8(4):e256372. doi:10.1001/ jamanetworkopen.2025.6372
  4. Sheahan KL, et al. J Gen Intern Med. 2022;37(Suppl 3):791-798. doi:10.1007/s11606-022-07585-3
  5. Adams RE, et al. BMC Womens Health. 2021;21(1):1-10. doi:10.1186/s12905-021-01183-z
  6. Haskell SG, et al. J Womens Health (Larchmt). 2010;19(2):267-271. doi:10.1089/jwh.2008.1262
  7. VHA Directive 1330.01(1): Health Care Services for Women Veterans. US Department of Veterans Affairs; February 15, 2023. Accessed May 23, 2025. https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=10576
  8. VHA Directive 1115(1): Military Sexual Trauma (MST) Program. US Department of Veterans Affairs; May 8, 2018. Accessed May 23, 2025. https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=6432
  9. Marshall V, et al. Womens Health Issues. 2021;31(2):150-157. doi:10.1016/j.whi.2020.10.005
  10. Washington DL, et al. J Gen Intern Med. 2011;26(suppl 2):655-661. doi:10.1007/s11606-011-1772-z
  11. Hadlandsmyth K, et al. Eur J Pain. 2024;28(8):1311-1319. doi:10.1002/ejp.2258
  12. Military Sexual Trauma Fact Sheet–VA Mental Health. US Department of Veterans Affairs. May 1, 2021. Accessed March 21, 2025. https://www.mentalhealth.va.gov/docs/mst_general_factsheet.pdf
  13. National Center for Veterans Analysis and Statistics. Population Tables: the nation, age/sex. US Department of Veterans Affairs website. Accessed March 21, 2025. https://www.va.gov/vetdata/Veteran_Population.asp
  14. Serving Her Country: Exploring the Characteristics of Women Veterans. US Department of Veterans Affairs. Accessed March 21, 2025. https://www.data.va.gov/stories/s/Women-Veterans-in-2023/wci3-yrsv/
  15. Gasperi M, et al. JAMA Netw Open. 2024;7(3):e242299. doi:10.1001/jamanetworkopen.2024.2299
  16. US Department of Veterans Affairs. Study of Barriers for Women Veterans to VA Health Care: Final Report. February 2024. Accessed March 21, 2025. https://www.womenshealth.va.gov/materials-and-resources/publications-and-reports.asp
  17. Iverson KM, et al. J Gen Intern Med. 2019;34(11):2435-2442. doi:10.1007/s11606-019-05240-y
  18. Spinelli S, et al. J Gen Intern Med. 2022;37(suppl 3):837-841. doi:10.1007/s11606-022-07577-3
  19. Carlson K, et al. In: StatPearls. StatPearls Publishing; 2025. Updated January 22,2025. Accessed March 21, 2025. https://www.ncbi.nlm.nih.gov/books/NBK519070/

  20. Monteith LL, et al. J Interpers Violence. 2023;38(11-12):7578-7601. doi:10.1177/08862605221145725

     

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Aliya R. Webermann, PhD, Staff Psychologist, Department of Psychology Service, VA Connecticut Healthcare System, West Haven, Connecticut; Associate Research Scientist, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut. Aliya R. Webermann, PhD, has disclosed no relevant financial relations:hips.

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Aliya R. Webermann, PhD, Staff Psychologist, Department of Psychology Service, VA Connecticut Healthcare System, West Haven, Connecticut; Associate Research Scientist, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut. Aliya R. Webermann, PhD, has disclosed no relevant financial relations:hips.

Click here to view more from Federal Health Care Data Trends 2025.

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References
  1. Women Veterans Health Care: Facts and Statistics. US Department of Veterans Affairs. Published 2022. Accessed May 23, 2025. https://www.womenshealth.va.gov/materials-and-resources/facts-and-statistics.asp
  2. Sourcebook: Women Veterans in the Veterans Health Administration. Volume 5: Longitudinal Trends in Sociodemographics and Utilization, Including Type, Modality, and Source of Care. US Department of Veterans Affairs; 2024. Accessed May 23, 2025. https://www.womenshealth.va.gov/WOMENSHEALTH/docs/VHA-Source-book-V5-FINAL.pdf
  3. Goldstein KM, et al. JAMA Netw Open. 2025;8(4):e256372. doi:10.1001/ jamanetworkopen.2025.6372
  4. Sheahan KL, et al. J Gen Intern Med. 2022;37(Suppl 3):791-798. doi:10.1007/s11606-022-07585-3
  5. Adams RE, et al. BMC Womens Health. 2021;21(1):1-10. doi:10.1186/s12905-021-01183-z
  6. Haskell SG, et al. J Womens Health (Larchmt). 2010;19(2):267-271. doi:10.1089/jwh.2008.1262
  7. VHA Directive 1330.01(1): Health Care Services for Women Veterans. US Department of Veterans Affairs; February 15, 2023. Accessed May 23, 2025. https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=10576
  8. VHA Directive 1115(1): Military Sexual Trauma (MST) Program. US Department of Veterans Affairs; May 8, 2018. Accessed May 23, 2025. https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=6432
  9. Marshall V, et al. Womens Health Issues. 2021;31(2):150-157. doi:10.1016/j.whi.2020.10.005
  10. Washington DL, et al. J Gen Intern Med. 2011;26(suppl 2):655-661. doi:10.1007/s11606-011-1772-z
  11. Hadlandsmyth K, et al. Eur J Pain. 2024;28(8):1311-1319. doi:10.1002/ejp.2258
  12. Military Sexual Trauma Fact Sheet–VA Mental Health. US Department of Veterans Affairs. May 1, 2021. Accessed March 21, 2025. https://www.mentalhealth.va.gov/docs/mst_general_factsheet.pdf
  13. National Center for Veterans Analysis and Statistics. Population Tables: the nation, age/sex. US Department of Veterans Affairs website. Accessed March 21, 2025. https://www.va.gov/vetdata/Veteran_Population.asp
  14. Serving Her Country: Exploring the Characteristics of Women Veterans. US Department of Veterans Affairs. Accessed March 21, 2025. https://www.data.va.gov/stories/s/Women-Veterans-in-2023/wci3-yrsv/
  15. Gasperi M, et al. JAMA Netw Open. 2024;7(3):e242299. doi:10.1001/jamanetworkopen.2024.2299
  16. US Department of Veterans Affairs. Study of Barriers for Women Veterans to VA Health Care: Final Report. February 2024. Accessed March 21, 2025. https://www.womenshealth.va.gov/materials-and-resources/publications-and-reports.asp
  17. Iverson KM, et al. J Gen Intern Med. 2019;34(11):2435-2442. doi:10.1007/s11606-019-05240-y
  18. Spinelli S, et al. J Gen Intern Med. 2022;37(suppl 3):837-841. doi:10.1007/s11606-022-07577-3
  19. Carlson K, et al. In: StatPearls. StatPearls Publishing; 2025. Updated January 22,2025. Accessed March 21, 2025. https://www.ncbi.nlm.nih.gov/books/NBK519070/

  20. Monteith LL, et al. J Interpers Violence. 2023;38(11-12):7578-7601. doi:10.1177/08862605221145725

     

References
  1. Women Veterans Health Care: Facts and Statistics. US Department of Veterans Affairs. Published 2022. Accessed May 23, 2025. https://www.womenshealth.va.gov/materials-and-resources/facts-and-statistics.asp
  2. Sourcebook: Women Veterans in the Veterans Health Administration. Volume 5: Longitudinal Trends in Sociodemographics and Utilization, Including Type, Modality, and Source of Care. US Department of Veterans Affairs; 2024. Accessed May 23, 2025. https://www.womenshealth.va.gov/WOMENSHEALTH/docs/VHA-Source-book-V5-FINAL.pdf
  3. Goldstein KM, et al. JAMA Netw Open. 2025;8(4):e256372. doi:10.1001/ jamanetworkopen.2025.6372
  4. Sheahan KL, et al. J Gen Intern Med. 2022;37(Suppl 3):791-798. doi:10.1007/s11606-022-07585-3
  5. Adams RE, et al. BMC Womens Health. 2021;21(1):1-10. doi:10.1186/s12905-021-01183-z
  6. Haskell SG, et al. J Womens Health (Larchmt). 2010;19(2):267-271. doi:10.1089/jwh.2008.1262
  7. VHA Directive 1330.01(1): Health Care Services for Women Veterans. US Department of Veterans Affairs; February 15, 2023. Accessed May 23, 2025. https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=10576
  8. VHA Directive 1115(1): Military Sexual Trauma (MST) Program. US Department of Veterans Affairs; May 8, 2018. Accessed May 23, 2025. https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=6432
  9. Marshall V, et al. Womens Health Issues. 2021;31(2):150-157. doi:10.1016/j.whi.2020.10.005
  10. Washington DL, et al. J Gen Intern Med. 2011;26(suppl 2):655-661. doi:10.1007/s11606-011-1772-z
  11. Hadlandsmyth K, et al. Eur J Pain. 2024;28(8):1311-1319. doi:10.1002/ejp.2258
  12. Military Sexual Trauma Fact Sheet–VA Mental Health. US Department of Veterans Affairs. May 1, 2021. Accessed March 21, 2025. https://www.mentalhealth.va.gov/docs/mst_general_factsheet.pdf
  13. National Center for Veterans Analysis and Statistics. Population Tables: the nation, age/sex. US Department of Veterans Affairs website. Accessed March 21, 2025. https://www.va.gov/vetdata/Veteran_Population.asp
  14. Serving Her Country: Exploring the Characteristics of Women Veterans. US Department of Veterans Affairs. Accessed March 21, 2025. https://www.data.va.gov/stories/s/Women-Veterans-in-2023/wci3-yrsv/
  15. Gasperi M, et al. JAMA Netw Open. 2024;7(3):e242299. doi:10.1001/jamanetworkopen.2024.2299
  16. US Department of Veterans Affairs. Study of Barriers for Women Veterans to VA Health Care: Final Report. February 2024. Accessed March 21, 2025. https://www.womenshealth.va.gov/materials-and-resources/publications-and-reports.asp
  17. Iverson KM, et al. J Gen Intern Med. 2019;34(11):2435-2442. doi:10.1007/s11606-019-05240-y
  18. Spinelli S, et al. J Gen Intern Med. 2022;37(suppl 3):837-841. doi:10.1007/s11606-022-07577-3
  19. Carlson K, et al. In: StatPearls. StatPearls Publishing; 2025. Updated January 22,2025. Accessed March 21, 2025. https://www.ncbi.nlm.nih.gov/books/NBK519070/

  20. Monteith LL, et al. J Interpers Violence. 2023;38(11-12):7578-7601. doi:10.1177/08862605221145725

     

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Women, the fastest-growing veteran subpopulation, represent over 10% of US veterans and are projected to reach 18% by 2040.1 Currently, 28% of women veterans use VHA services, with 44% receiving VHA-funded community care.2 While 86% of VHA women veterans are under 65, the population is aging.3,4 Compared to male veterans, women experience higher rates of depression, anxiety, military sexual trauma (MST), musculoskeletal conditions, chronic pain, and PTSD—though evidence on sex differences in PTSD is mixed.5,6 Women veterans also face pregnancy-related challenges, including childcare barriers, difficulty discontinuing pain medications, poor VHA-obstetric coordination, and higher perinatal mortality. In 2010, VHA Directive 1330 established standards for women’s healthcare, including designated women’s health providers.7 In 2018, Directive 1115 outlined MST-related care, screening, and free treatment.8 Despite progress in women’s healthcare and a greater sense of welcome at VHA, gaps persist in provider availability, community care coordination, and harassment within facilities.9 Women veterans also report barriers such as lack of insurance, unaffordable care, transportation issues, and inability to take time off work.10

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References

1. US Department of Veterans Affairs. VA improving diabetes care with patient generated health data. VA News. March 12, 2025. Accessed April 24, 2025. https://news.va.gov/138644/va-diabetes-care-with-patient-generated-data/
2. Diabetes basics. Centers for Disease Control and Prevention. May 15, 2024. Accessed April 24, 2025. https://www.cdc.gov/diabetes/about/index.html
3. Hua S, et al. Diabetes Care. 2024;47(11):1978-1984. doi:10.2337/dc24-0892
4. Lipska KJ, et al. Diabetes Technol Ther. 2024;26(12):908-917. doi:10.1089/dia.2024.0152
5. Yoon J, et al. J Gen Intern Med. 2025;40(3):647-653. doi:10.1007/s11606-024-08968-4

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Reviewed by: Ricardo Correa, MD, EdD, Clinical Professor of Medicine, Endocrinology Institute, Lerner College of Medicine of CWRU; Endocrinology fellowship director, Cleveland Clinic, Ohio.
Ricardo Correa, MD, EdD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: American association of clinical endocrinologist; Endocrine fellow foundation; Intealth (ECFMG).

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Reviewed by: Ricardo Correa, MD, EdD, Clinical Professor of Medicine, Endocrinology Institute, Lerner College of Medicine of CWRU; Endocrinology fellowship director, Cleveland Clinic, Ohio.
Ricardo Correa, MD, EdD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: American association of clinical endocrinologist; Endocrine fellow foundation; Intealth (ECFMG).

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Reviewed by: Ricardo Correa, MD, EdD, Clinical Professor of Medicine, Endocrinology Institute, Lerner College of Medicine of CWRU; Endocrinology fellowship director, Cleveland Clinic, Ohio.
Ricardo Correa, MD, EdD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: American association of clinical endocrinologist; Endocrine fellow foundation; Intealth (ECFMG).

Click here to view more from Federal Health Care Data Trends 2025.

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References

1. US Department of Veterans Affairs. VA improving diabetes care with patient generated health data. VA News. March 12, 2025. Accessed April 24, 2025. https://news.va.gov/138644/va-diabetes-care-with-patient-generated-data/
2. Diabetes basics. Centers for Disease Control and Prevention. May 15, 2024. Accessed April 24, 2025. https://www.cdc.gov/diabetes/about/index.html
3. Hua S, et al. Diabetes Care. 2024;47(11):1978-1984. doi:10.2337/dc24-0892
4. Lipska KJ, et al. Diabetes Technol Ther. 2024;26(12):908-917. doi:10.1089/dia.2024.0152
5. Yoon J, et al. J Gen Intern Med. 2025;40(3):647-653. doi:10.1007/s11606-024-08968-4

References

1. US Department of Veterans Affairs. VA improving diabetes care with patient generated health data. VA News. March 12, 2025. Accessed April 24, 2025. https://news.va.gov/138644/va-diabetes-care-with-patient-generated-data/
2. Diabetes basics. Centers for Disease Control and Prevention. May 15, 2024. Accessed April 24, 2025. https://www.cdc.gov/diabetes/about/index.html
3. Hua S, et al. Diabetes Care. 2024;47(11):1978-1984. doi:10.2337/dc24-0892
4. Lipska KJ, et al. Diabetes Technol Ther. 2024;26(12):908-917. doi:10.1089/dia.2024.0152
5. Yoon J, et al. J Gen Intern Med. 2025;40(3):647-653. doi:10.1007/s11606-024-08968-4

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Nearly 25% of veterans who receive VA care have diabetes, compared with about 10% of the US population.1,2 Within the VA, diabetes is the leading cause of long-term complications such as blindness, kidney failure, and amputation.1

Over the past decade, racial and ethnic disparities in early glycemic control have narrowed within the veteran, but differences in continuous glucose monitor (CGM) prescriptions remain.3,4

The quality of diabetes management also varies depending on where veterans receive their care. A recent study showed that veterans seeking care in community settings had lower rates of diabetes testing and immunizations, fewer primary care visits, higher rates of hospitalization, and higher health care costs compared with veterans who were treated directly within the VA.5

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