i agree - although the fatty layer may be reduced - its likely the collagen that is responsible for the structure of this tissue that is actually the root cause
several chronic bacterial infections can cause tissue loss - due to upregulated inflammatory changes in the blood vessels and skin
however infections with borrelial species ( I.e. Lyme disease ) are most notable for this presentation as it is known to break down collagen in particular and also elastin
example paper here
Damage of Collagen and Elastic Fibres by Borrelia Burgdorferi – Known and New Clinical and Histopathological Aspects
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3751012/
in my experience, almost all chromic lyme patients have collagen loss
testing is very poor - primary care providers are either ignorant about the disease and its prevalence - or are miseducated - many many cases are missed or passed off as something else - CFS being the most common mis diagnosis given by primary care doctors in multiple published studies
there have also been studies investigating why this happens - and in these studies individual doctors were interviewed anonymously - where they stated that they felt personal risk to their livelihood if they diagnosed Lyme disease - because of controversy in the medical profession around the disease's - and the fact that long courses of antibiotics are frowned upon.
but they also stated they felt at personal risk of patient action if they did not diagnose lyme disease - because they felt they could be subject to malpractice suits etc from disgruntled patients
They therefore felt they were in a no-win situation and that they therefore feel the safest course of action was to make no mention of Lyme disease at all in the diagnosis record - and instead use a term that no one can test for to confirm or deny - eg CFS or Fibromyalgia.
this is exactly what happened to me and my fiancé who both became ill with Lyme disease after a picnic on farm land.
- doctors denied that lyme disease was present in my region - i later found 2 universities had in fact studied the surrounding area and even the park in our local town had a high prevalence of ticks infected with lyme disease
- doctors denied that our symptoms matched lyme disease - saying we would be much sicker than we were and becoming sicker by the day - but studies show chronic lyme is anything but a rapidly progressing illness - it is instead characterised by years or decades of illness - and a significant portion of diagnosed lyme disease sufferers can actually still hold down jobs - so - they were just ignorant of the facts
- doctors stated our inflammatory markers would be off the charts if we had lyme disease - later reading shows this is rarely the case with chronic lyme disease - again they just didn't know what they were talking about - but were adamant they did.
so it seems sadly - doctors who took the hypocratic oath to put patients needs first and do no harm - are in fact prioritising their own prosperity - and doing untold amount of harm by refusing to follow the science , preferring to cover their own asses
many here may well have been fobbed off with this same complete nonsense - because it is typically stated with confidence as if its an established fact - when in reality they know nothing about the disease and want to have even less to do with it.