eMedicine Specialties > Dermatology > Diseases of the Subcutaneous Tissue

Adiposis Dolorosa: Follow-up

Author: Marjan Yousefi, MD, Department of Dermatology, Geisinger Medical Center
Coauthor(s): Tammie Ferringer, MD, Teaching Staff, Departments of Dermatology and Pathology, Geisinger Medical Center; Nada MacAron, MD, Staff Physician, Department of Pathology, Emory University School of Medicine
Contributor Information and Disclosures

Updated: May 15, 2009

Follow-up

Complications

  • Dercum disease (adiposis dolorosa) can be debilitating and can lead to incapacitation. Also, because Dercum disease (adiposis dolorosa) symptoms are nonspecific, unnecessary medical procedures, tests, and operations can result in several complications.
  • Although rare, septicemia leading to septic shock, following necrosis of a fatty tumor, has been reported.25

Prognosis

  • The course is of Dercum disease (adiposis dolorosa) chronic and progressive.

Patient Education

  • Educating patients about the chronicity of Dercum disease (adiposis dolorosa) and the available limited treatment modalities is important. Proper education about the aggravating and relieving factors should be explained.
  • Patient education about Dercum disease (adiposis dolorosa) is crucial. Addressing any possible needs of those persons with disabilities is important, preferably with the assistance of an occupational therapist and a social worker. Various aids may be needed in the home and at work.
  • The Dercum Group was formed in 1990 in Lund, Sweden. The group, which is a part of the Association for Rheumatics, is nationwide and has approximately 300 members. It works to provide support and information to both individual members and other interested parties.
 


More on Adiposis Dolorosa

Overview: Adiposis Dolorosa
Differential Diagnoses & Workup: Adiposis Dolorosa
Treatment & Medication: Adiposis Dolorosa
Follow-up: Adiposis Dolorosa
References
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References

  1. Dercum FX. Three cases of a hitherto unclassified affection resembling in its grosser aspects obesity, but associated with special symptoms: adiposis dolorosa. Am J Med Sci. 1892;104:521-35.

  2. Palmer ED. Dercum's disease: adiposis dolorosa. Am Fam Physician. Nov 1981;24(5):155-7. [Medline].

  3. Brodovsky S, Westreich M, Leibowitz A, Schwartz Y. Adiposis dolorosa (Dercum's disease): 10-year follow-up. Ann Plast Surg. Dec 1994;33(6):664-8. [Medline].

  4. Greenbaum SS, Varga J. Corticosteroid-induced juxta-articular adiposis dolorosa. Arch Dermatol. Feb 1991;127(2):231-3. [Medline].

  5. Skagen K, Petersen P, Kastrup J, Norgaard T. The regulation of subcutaneous blood flow in patient with Dercum's disease. Acta Derm Venereol. 1986;66(4):337-9. [Medline].

  6. Lynch HT, Harlan WL. Hereditary Factors in Adiposis Dolorosa (Dercum's Disease). Am J Hum Genet. Jun 1963;15(2):184-90. [Medline].

  7. Cantu JM, Ruiz-Barquin E, Jimenez M, Castillo L, Macotela-Ruiz E. Autosomal dominant inheritance in adiposis dolorosa (Dercum's disease). Humangenetik. Mar 23 1973;18(1):89-91. [Medline].

  8. Campen R, Mankin H, Louis DN, Hirano M, Maccollin M. Familial occurrence of adiposis dolorosa. J Am Acad Dermatol. Jan 2001;44(1):132-6. [Medline].

  9. Leites SM, Davtian NK, Emanuel' VIa. [Pathophysiological characteristics of adipose tissue in Dercum's syndrome]. Patol Fiziol Eksp Ter. Jan-Feb 1972;16(1):47-51. [Medline].

  10. Blomstrand R, Juhlin L, Nordenstam H, Ohlsson R, Werner B, Engstrom J. Adiposis dolorosa associated with defects of lipid metabolism. Acta Derm Venereol. 1971;51(4):243-50. [Medline].

  11. Gamez J, Playan A, Andreu AL, et al. Familial multiple symmetric lipomatosis associated with the A8344G mutation of mitochondrial DNA. Neurology. Jul 1998;51(1):258-60. [Medline].

  12. Silvestri G, Ciafaloni E, Santorelli FM, et al. Clinical features associated with the A-->G transition at nucleotide 8344 of mtDNA ("MERRF mutation"). Neurology. Jun 1993;43(6):1200-6. [Medline].

  13. Stallworth JM, Hennigar GR, Jonsson HT Jr, Rodriguez O. The chronically swollen painful extremity. A detailed study for possible etiological factors. JAMA. Jun 24 1974;228(13):1656-9. [Medline].

  14. Amine B, Leguilchard F, Benhamou CL. Dercum's disease (adiposis dolorosa): a new case-report. Joint Bone Spine. Mar 2004;71(2):147-9. [Medline].

  15. Freedberg IM, Eisen AZ, Wolff K et al, eds. Neoplasms of subcutaneous fat. In: Dermatology in General Medicine. Vol 1. 5th ed. New York, NY: McGraw-Hill; 1999:1348-9.

  16. Fagher B, Monti M, Nilsson-Ehle P, Akesson B. Fat-cell heat production, adipose tissue fatty acids, lipoprotein lipase activity and plasma lipoproteins in adiposis dolorosa. Clin Sci (Lond). Dec 1991;81(6):793-8. [Medline].

  17. Campen RB, Sang CN, Duncan LM. Case records of the Massachusetts General Hospital. Case 25-2006. A 41-year-old woman with painful subcutaneous nodules. N Engl J Med. Aug 17 2006;355(7):714-22. [Medline].

  18. Iwane T, Maruyama M, Matsuki M, Ito Y, Shimoji K. Management of intractable pain in adiposis dolorosa with intravenous administration of lidocaine. Anesth Analg. Mar-Apr 1976;55(2):257-9. [Medline].

  19. Petersen P, Kastrup J. Dercum's disease (adiposis dolorosa). Treatment of the severe pain with intravenous lidocaine. Pain. Jan 1987;28(1):77-80. [Medline].

  20. Gonciarz Z, Mazur W, Hartleb J, et al. Interferon alfa-2b induced long-term relief of pain in two patients with adiposis dolorosa and chronic hepatitis C. J Hepatol. Dec 1997;27(6):1141. [Medline].

  21. Steiner J, Schiltz K, Heidenreich F, Weissenborn K. [Lipomatosis dolorosa--a frequently overlooked disease picture]. Nervenarzt. Feb 2002;73(2):183-7. [Medline].

  22. Singal A, Janiga JJ, Bossenbroek NM, Lim HW. Dercum's disease (adiposis dolorosa): a report of improvement with infliximab and methotrexate. J Eur Acad Dermatol Venereol. May 2007;21(5):717. [Medline].

  23. Desai MJ, Siriki R, Wang D. Treatment of pain in Dercum's disease with Lidoderm (lidocaine 5% patch): a case report. Pain Med. Nov 2008;9(8):1224-6. [Medline].

  24. Lange U, Oelzner P, Uhlemann C. Dercum's disease (Lipomatosis dolorosa): successful therapy with pregabalin and manual lymphatic drainage and a current overview. Rheumatol Int. Nov 2008;29(1):17-22. [Medline].

  25. Haddad D, Athmani B, Costa A, Cartier S. [Dercum's disease: a severe complication in a rare disease. A case report]. Ann Chir Plast Esthet. Jun 2005;50(3):247-50. [Medline].

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Further Reading

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Keywords

adiposis dolorosa, Dercum's disease, Dercum disease, painful lipoma, fatty tissue rheumatism, juxta-articular adiposis dolorosa (occurs around the knees)

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Contributor Information and Disclosures

Author

Marjan Yousefi, MD, Department of Dermatology, Geisinger Medical Center
Marjan Yousefi, MD is a member of the following medical societies: American Academy of Dermatology and Phi Beta Kappa
Disclosure: Nothing to disclose.

Coauthor(s)

Tammie Ferringer, MD, Teaching Staff, Departments of Dermatology and Pathology, Geisinger Medical Center
Tammie Ferringer, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and American Society of Dermatopathology
Disclosure: Nothing to disclose.

Nada MacAron, MD, Staff Physician, Department of Pathology, Emory University School of Medicine
Nada MacAron, MD is a member of the following medical societies: College of American Pathologists and United States and Canadian Academy of Pathology
Disclosure: Nothing to disclose.

Medical Editor

Catharine Lisa Kauffman, MD, FACP, Georgetown Dermatology and Georgetown Dermpath
Catharine Lisa Kauffman, MD, FACP is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Royal Society of Medicine, Society for Investigative Dermatology, and Women's Dermatologic Society
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Managing Editor

Rosalie Elenitsas, MD, Herman Beerman Associate Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System
Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology and American Society of Dermatopathology
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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