Stage III lipedema is characterized by which feature?

• A. Stage II: uneven knotted fat
• B. Stage I: smooth surface
• C. Stage IV: additional severe lipolymphedema
• D. Stage III: coarse tissue with large lobed deformities

Answer: (D)

Stage III lipedema is identified by coarse tissue with large lobed deformities, giving the limb a bulky, irregular contour. This reflects progression from earlier stages, where Stage I has a smooth surface and Stage II shows uneven, knotted fat. When it advances to Stage IV, lipolymphedema with added swelling from lymphatic involvement can occur. Recognizing the lobulated, rough tissue pattern of Stage III helps distinguish it from earlier stages and guides clinical expectations and management.