Diagnosis
Familial multiple lipomatosis is usually diagnosed through a physical exam via palpation, medical history and imaging studies such as ultrasound, CT scan, or magnetic resonance imaging (MRI). A CT scan is an imaging method that uses x-rays to create images of cross sections of the body, while an MRI uses powerful magnets and radio waves to create images of lipomas and surrounding tissues. Both tests are useful to establish the diagnosis of multiple symmetric lipomatosis, although magnetic resonance imaging provides more details and may be used when lipomas are large, deep, or have infiltrated muscle fibers or nerves. In some cases, a biopsy of the lipomas may be necessary to confirm the diagnosis. Differential diagnoses
Liposarcoma
Dercum’s disease
Benign symmetric lipomatosis
Madelung’s disease
Cyst

Causes
The exact cause of FML is not yet known, but there are several theories of different causes:
Hormonal disorder due to the bodys inability to properly metabolize fat
Increase in fat cells (adipocytes)
Enzymatic defect or a change in the surface of the cells that could prevent the breakdown of fat
Poor lymphatic drainage
Defective regulation of mitochondria in brown fat. Brown fat is responsible for causing heat in times of stress or cold. For general callus tissue is stimulated by the sympathetic nervous system and this response is mediated by a substance called norepinephrine. This process occurs in the mitochondria
In most families, the mode of inheritance has not been determined. However, changes (mutations) in mitochondrial DNA that involve the MT-TK gene have been identified in some families who have the disease and other conditions that affect many different body systems.
Cutis verticis gyrata is a medical condition usually associated with thickening of the scalp. The condition is identified by excessive thickening of the soft tissues of the scalp and characterized by ridges and furrows, which give the scalp a cerebriform appearance. Clinically, the ridges are hard and cannot be flattened on applying pressure. Patients show visible folds, ridges or creases on the surface of the top of the scalp. The number of folds can vary from two to roughly ten and are typically soft and spongy. The condition typically affects the central and rear regions of the scalp, but sometimes can involve the entire scalp. Hair loss can occur over time where the scalp thickens, though hair within any furrows remains normal. Thus far, due to the (apparent) rarity of the condition, limited research exists and causes are as yet undetermined. What is known, is that the condition is not exclusively congenital. The condition was first reported by Jean-Louis-Marc Alibert in 1837, who called it cutis sulcata. A clinical description of the condition was provided by Robert in 1843 and it was named by Paul Gerson Unna in 1907. It has also been called Robert-Unna syndrome, bulldog scalp, corrugated skin, cutis verticis plicata, and pachydermia verticis gyrata. Cause
At this time, causes are unknown, but it is believed to not be congenital. Diagnosis
There is no clinical diagnosis for CVG as cases are rarely seen and are often comorbid with other conditions. Classifications
CVG is classified according to the presence, or lack of underlying cause.