ADIPOSIS DOLOROSA (DERCUM'S DISEASE)
By Gary M. White, MD
Adiposis Dolorosa (AD) or Dercum's disease is the combination of generalised overweight or obesity and painful adipose tissue. It is a syndrome that continues to be defined and classified.
- Various symptoms are commonly associated including easy bruisability, sleep disturbances, impaired memory, depression, difficulty concentrating, anxiety, rapid heartbeat, shortness of breath, diabetes, bloating, constipation, fatigue, weakness and joint aches.
- AD is most common between the ages of 35 and 50 years and is five to thirty times more common in women than in men.
Recently, the following classification has been proposed [Orphanet J Rare Dis. 2012 Apr 30;7:23]
| Generalised Diffuse
|| Diffusely widespread painful adipose tissue without clear lipomas
| Generalised Nodular
|| General pain in adipose tissue and intense pain in and around multiple lipomas
| Localised Nodular
|| Pain in and around multiple lipomas
|| Solitary deposits of excess fat for example at the medial aspect of the knee
Referral to a chronic pain specialist may be in order. The following treatments have had some success: liposuction, analgesics, lidocaine, methotrexate and infliximab, interferon α-2b, corticosteroids, calcium-channel modulators and rapid cycling hypobaric pressure.
Nice picture of Type 1 AD in an adult woman. Orphanet J Rare Dis. 2012 Apr 30;7:23
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