**4.1 Barraquer-Simons syndrome**

Barraquer-Simons syndrome (OMIM #608709) is named after Barraquer and Simons who first described the disease in the 1900s. Unlike other lipodystrophies, Barraquer-Simons syndrome occurs not due to inherited genetic mutations but normally derives from an acute viral transfection, such as measles [60]. Barraquer-Simons syndrome is extremely rare, with approximately 250 cases that have been reported in the literature with a male-to-female ratio of 1:4 [137]. The syndrome results in loss of subcutaneous fat mainly in the upper part of the body (face, neck, arms, and thorax) and upper abdomen; however, some adipose tissues are preserved in the gluteal regions and lower extremities [138]. Fortunately, Barraquer-Simons syndrome does not normally induce other metabolic complications such as insulin resistance, diabetes, and hypertriglyceridemia [137].
