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Dercum's Disease (Adiposis Dolorosa): Symptoms, Causes And Treatment

Dercum's disease also called as adiposis dolorosa or Anders disease is an extremely rare condition which causes the growth of painful fatty tissues called lipomas [1] . The lipomas grow just below the skin and affect the torso, upper arms, or upper legs. The disorder is commonly found in women (five to thirty times more). The lack of studies on the disease makes it a less understood area, but it has been asserted that the condition does not affect one's life expectancy [2] .

The size of the lipoma can range from that of a small marble to a human fist. In some people, all the lipomas will be of the same size and in some, it can be of varying sizes. The rare disorder was first described by Francis Xavier Decrum at Jefferson Medical College in 1892 [3] . The tumours are usually painful and can be very concerning to the affected individuals.

Symptoms Of Dercum's Disease

The signs of the condition can vary from one individual to the other. But, the one common symptom associated with Dercum's disease is painful lipomas that grow slowly [4] .

Other signs and symptoms of the disease are as follows [5] :

  • Weight gain
  • Shortness of breath
  • Fatigue
  • Weakness
  • Stiffness after laying down, especially in the morning
  • Depression
  • Problems with thinking, concentration, or memory
  • Easy bruising
  • Swelling that comes and goes in different parts of the body, often the hands
  • Constipation
  • Irritability
  • Difficulty sleeping
  • Rapid heart rate
  • Headaches
  • Mental issues such as depression, epilepsy, dementia or feeling confused

Causes Of Dercum's Disease

To this day, the reason behind the condition is not known. The lack of clarity on the cause of Dercum's disease has resulted in studies being conducted on understanding the origin of the disease [6] .

According to recent studies, it has been incurred that Decrum's disease is an autoimmune disorder, which is a condition that causes your immune system to mistakenly attack your healthy tissue. Other studies point out that it is a metabolic problem related to the limited ability to properly break down fat.

Diagnosis Of Dercum's Disease

The disease does not have any specific diagnosing criteria. Your doctor will run tests to rule out the possibilities of conditions such as fibromyalgia or lipedema. In order to carry that out, the doctor will biopsy one of your lipomas; which will involve extracting a sample tissue and examining it under the microscope. The diagnosis may also involve a CT scan or MRI scan [7] , [8] .

If the diagnosis shows that you have Decrum's disease, the doctor will classify the condition based on the size and location of the lipomas. The lipomas are classified as nodular (large lipomas, usually around your arms, back, abdomen, or thighs), diffuse (small lipomas that are widespread) and mixed (a combination of both large and small lipomas) [9] .

Treatment For Dercum's Disease

The condition does not have any cure. The treatment methods focus on relieving the symptoms, that is, managing the pain associated with the lipomas. Some of the treatment methods are as follows [10] , [11] , [12] :

Medications: Pain killers will be prescribed for pain management and swelling. Diuretics or water pills are prescribed to reduce swelling. Other drugs may help with the pain such as corticosteroids, lidocaine etc.

Surgery: In some cases, the doctor will advise the removal of fatty growths. It can help relieve the pain for a long period of time. However, there are chances that the lipomas may grow back.

Liposuction: This procedure can help get rid of the extra fat, which will help reduce the pain.

Alternative therapies: Acupuncture, hypnosis, and biofeedback can help cope with the condition in a better manner.

Some of the other treatment methods are providing emotional support and eating healthy.

View Article References
  1. [1] Petersen, P., & Kastrup, J. (1987). Dercum's disease (adiposis dolorosa). Treatment of the severe pain with intravenous lidocaine. Pain, 28(1), 77-80.
  2. [2] Lynch, H. T., & Harlan, W. L. (1963). Hereditary factors in adiposis dolorosa (Dercum's disease). American journal of human genetics, 15(2), 184.
  3. [3] Wortham, N. C., & Tomlinson, I. P. (2005). Dercum's disease. SKINmed: Dermatology for the Clinician, 4(3), 157-162.
  4. [4] DeFranzo, A. J., Hall, J. J., & Herring, S. M. (1990). Adiposis dolorosa (Dercum's disease): liposuction as an effective form of treatment. Plastic and reconstructive surgery, 85(2), 289-292.
  5. [5] Brodovsky, S., Westreich, M., Leibowitz, A., & Schwartz, Y. (1994). Adiposis dolorosa (Dercum's disease): 10-year follow-up. Annals of plastic surgery, 33(6), 664-668.
  6. [6] Berntorp, E., Berntorp, K., Brorson, H., & Frick, K. (1998). Liposuction in Dercum's disease: impact on haemostatic factors associated with cardiovascular disease and insulin sensitivity. Journal of internal medicine, 243(3), 197-202.
  7. [7] Amine, B., Leguilchard, F., & Benhamou, C. L. (2004). Dercum’s disease (adiposis dolorosa): a new case-report. Joint Bone Spine, 71(2), 147-149.
  8. [8] Hansson, E., Svensson, H., & Brorson, H. (2012). Review of Dercum’s disease and proposal of diagnostic criteria, diagnostic methods, classification and management. Orphanet journal of rare diseases, 7(1), 23.
  9. [9] Rosenberg, B., Hurwitz, A., & Hermann, H. (1963). Dercum's disease with unusual retroperitoneal and paravesical fatty infiltration. Surgery, 54(3), 451-455.
  10. [10] Wollina, U., Goldman, A., & Heinig, B. (2010). Microcannular tumescent liposuction in advanced lipedema and Dercum’s disease. G Ital Dermatol Venereol, 145(2), 151-9.
  11. [11] Steiger, W. A., Litvin, H., Lasche, E. M., & Durant, T. M. (1952). Adiposis dolorosa (Dercum's disease). New England Journal of Medicine, 247(11), 393-396.
  12. [12] Reece, P. H., Wyatt, M., & O'Flynn, P. (1999). Dercum's disease (adiposis dolorosa). The Journal of Laryngology & Otology, 113(2), 174-176.

Read more about: disease
Story first published: Friday, May 3, 2019, 12:29 [IST]
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