Familial lipoma syndrome, an autosomal dominant trait appearing in early adulthood, consists of hundreds of slowly growing nontender lesions. Adipositas dolorosa, or Dercum's disease, occurs in women in middle age; there are multiple tender, not circumscribed but rather diffuse fatty deposits. Benign symmetric lipomatosis, which affects middle-aged men, consists of many large nontender, coalescent poorly circumscribed lipomas, mostly on the trunk and upper extremities; they coalesce on the neck and may lead to a “horse-collar” appearance. Shown here are multiple lipomas on the lower arm in a 50-year-old male patient. In this patient lesions were symmetric and were also found on the trunk and lower extremities.