Dercum’s disease, or adiposis dolorosa, is a rare condition characterized by multiple, painful lipomas, or small benign fatty tumors. These lipomas mainly occur on the trunk, the upper arms and upper legs. The understanding of the cause and mechanism of Dercum disease remains unknown. Possible causes ranges from tissue trauma to congenital.
Dercum’s disease most commonly appears between the ages of 35 and 50 years of age. It is five to thirty times more common in women than in men. The prevalence of Dercum’s disease has not yet been exactly established.
Multiple lipomas and pain are the main symptoms of this disease. The associated symptoms in Dercum’s disease include easy bruisability, sleep disturbances, impaired memory, depression, difficulty concentrating, anxiety, rapid heartbeat, shortness of breath, bloating, constipation, fatigue, weakness and joint and muscle aches.
A diagnosis of Dercum’s disease is based on patient history and the physical findings. There are no specific laboratory test for this disease. High resolution ultrasound imaging or MRI can help with the diagnosis and is part of the workup.
Surgical excision of fatty tissue deposits around painful areas that are subject to a significant amount of physical contact using traditional surgery or liposuction has been used with good results. Because it is often a recurrent condition, we at NYC Surgical Associates favor the least invasive techniques to minimize tissue trauma, scarring, and lower the risk and complexity of any procedures that are needed in the future.
The pain in Dercum’s disease is often reported to be refractory to traditional pain medications and anti-inflammatory agents. Anesthetic medications injected into the small tumors has helped for varied amounts of time in different studies, but often requires repeated dosing.
A few patients noted some improvement when treated with systemic corticosteroids, but there are also reports of this worsening the pain in a small number of patients for unknown reasons.
The best option for you requires a discussion with your surgeon that involves advanced imaging to identify the location of the problem, and the type of symptoms you are having. With this information we can create a custom treatment plan to treat your issue with the least invasive, lowest risk option possible.