Adiposis dolorosa

A rare condition characterized by painful lipomas

Adiposis dolorosa
Nervous and mental diseases (1919) (14781727145).jpg
A patient with adiposis dolorosa showing fatty deposits
Synonyms	Dercum's disease, Anders disease
Specialty	Endocrinology, Neurology, Rheumatology
Symptoms	Painful fatty tumors, chronic pain, fatigue, weight gain, memory issues, depression
Complications	Impaired mobility, mental health challenges, social isolation
Usual onset	Typically between ages 35 and 50
Duration	Chronic, lifelong
Types	Generalized, nodular, localized, juxta-articular
Causes	Unknown; possibly related to nervous system, autoimmune or metabolic dysfunction
Risk factors	More common in women, especially those who are overweight or obese
Diagnosis	Based on clinical symptoms and exclusion of other conditions
Differential diagnosis	Lipomas, fibromyalgia, multiple lipomatosis, lipoedema
Prevention	None known
Treatment	Pain management, physical therapy, psychological support
Medication	Analgesics, antidepressants, anticonvulsants (for neuropathic pain)
Prognosis	Variable; chronic pain often persists, but not life-threatening
Frequency	Rare
Deaths	Not typically fatal

Adiposis dolorosa, also known as Dercum's disease, is a rare condition characterized by multiple painful lipomas, which are benign tumors composed of adipose tissue. This condition predominantly affects adults and is more common in women than in men.

Signs and symptoms

Individuals with adiposis dolorosa typically present with multiple, painful lipomas located primarily on the trunk, upper arms, and upper legs. The pain associated with these lipomas can be severe and is often described as burning or aching. In addition to the lipomas, patients may experience fatigue, weakness, and emotional disturbances such as depression and anxiety.

Pathophysiology

The exact cause of adiposis dolorosa is not well understood. It is believed to involve abnormalities in the nervous system and adipose tissue metabolism. Some researchers suggest that the pain may be due to nerve compression by the lipomas or an inflammatory process within the adipose tissue. There is also evidence to suggest a possible genetic component, as the condition can run in families.

Diagnosis

The diagnosis of adiposis dolorosa is primarily clinical, based on the presence of painful lipomas and associated symptoms. Imaging studies such as ultrasound or MRI may be used to assess the lipomas and rule out other conditions. A biopsy of the lipomas can confirm the diagnosis by showing mature adipose tissue without atypical features.

Treatment

There is no cure for adiposis dolorosa, and treatment is primarily symptomatic. Pain management is a key component and may include analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), and in some cases, opioids. Surgical removal of the lipomas may be considered for those causing significant pain or discomfort. Other treatments that have been explored include liposuction, corticosteroid injections, and physical therapy.

Prognosis

The prognosis for individuals with adiposis dolorosa varies. While the condition is chronic and can significantly impact quality of life, it is not life-threatening. The severity of symptoms can fluctuate, and some patients may experience periods of remission.

Related pages

• Lipoma
• Adipose tissue
• Chronic pain
• Rare diseases