Dercum's disease: Difference between revisions
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{{Infobox medical condition | |||
| name = Dercum's disease | |||
| image = [[File:CC-BY_icon.svg|alt=Image of Dercum's disease]] | |||
| image_size = 250px | |||
| alt = | |||
| caption = | |||
| pronounce = | |||
| specialty = [[Rheumatology]], [[Neurology]] | |||
| symptoms = Painful [[lipomas]], [[fatigue]], [[weakness]], [[depression (mood)|depression]] | |||
| onset = [[Middle age]] | |||
| duration = [[Chronic (medicine)|Chronic]] | |||
| types = | |||
| causes = Unknown | |||
| risks = | |||
| diagnosis = [[Clinical diagnosis]], [[imaging]] | |||
| differential = [[Lipomatosis]], [[fibromyalgia]], [[lipedema]] | |||
| prevention = | |||
| treatment = [[Pain management]], [[surgery]], [[weight loss]] | |||
| medication = [[Analgesics]], [[corticosteroids]] | |||
| prognosis = Variable | |||
| frequency = Rare | |||
| deaths = | |||
}} | |||
{{Short description|Rare condition characterized by painful fatty tumors}} | {{Short description|Rare condition characterized by painful fatty tumors}} | ||
{{Infobox medical condition | {{Infobox medical condition | ||
| Line 21: | Line 45: | ||
}} | }} | ||
'''Dercum's disease''' is a rare and chronic condition characterized by the presence of painful [[lipoma]]s (benign fatty tumors), usually found in multiples throughout the [[adipose tissue]] of the body. The disease often coexists with [[obesity]] and is more frequently diagnosed in [[middle-aged]] women, especially those who are postmenopausal. Dercum's disease was first described in 1892 by American neurologist '''Francis Xavier Dercum''' at [[Jefferson Medical College]]. | '''Dercum's disease''' is a rare and chronic condition characterized by the presence of painful [[lipoma]]s (benign fatty tumors), usually found in multiples throughout the [[adipose tissue]] of the body. The disease often coexists with [[obesity]] and is more frequently diagnosed in [[middle-aged]] women, especially those who are postmenopausal. Dercum's disease was first described in 1892 by American neurologist '''Francis Xavier Dercum''' at [[Jefferson Medical College]]. | ||
The condition was historically referred to as '''Adiposis dolorosa''', but this term is now considered obsolete, and Dercum’s disease is recognized as a distinct entity separate from conditions such as [[lipedema]] or [[multiple symmetric lipomatosis]]. | |||
The condition was historically referred to as '''Adiposis dolorosa''', but this term is now considered obsolete, and | |||
==Signs and symptoms== | ==Signs and symptoms== | ||
The clinical presentation of | The clinical presentation of Dercum’s disease is highly variable, but it typically includes a combination of the following cardinal features: | ||
* Chronic pain in the [[adipose tissue]] | * Chronic pain in the [[adipose tissue]] | ||
* [[Obesity]] or abnormal fat distribution | * [[Obesity]] or abnormal fat distribution | ||
* [[Fatigue]] and muscle weakness | * [[Fatigue]] and muscle weakness | ||
* [[Emotional instability]], which may include [[depression]], [[anxiety]], [[confusion]], and occasionally [[dementia]] or [[epilepsy]] | * [[Emotional instability]], which may include [[depression]], [[anxiety]], [[confusion]], and occasionally [[dementia]] or [[epilepsy]] | ||
Additional signs and associated symptoms that have been reported in patients with Dercum’s disease include: | |||
Additional signs and associated symptoms that have been reported in patients with | |||
* Easy [[bruising]] | * Easy [[bruising]] | ||
* [[Sleep disturbances]] | * [[Sleep disturbances]] | ||
| Line 42: | Line 61: | ||
* [[Constipation]] and [[bloating]] | * [[Constipation]] and [[bloating]] | ||
* [[Diabetes mellitus]] or [[glucose intolerance]] | * [[Diabetes mellitus]] or [[glucose intolerance]] | ||
Due to the heterogeneity of symptoms, there is no universally accepted diagnostic criterion. However, a proposed “minimal definition” includes: | |||
Due to the heterogeneity of symptoms, there is no universally accepted diagnostic criterion. However, a proposed | |||
# Generalized [[overweight]] or [[obesity]] | # Generalized [[overweight]] or [[obesity]] | ||
# Chronic [[pain]] in [[subcutaneous fat]] or [[lipomas]] | # Chronic [[pain]] in [[subcutaneous fat]] or [[lipomas]] | ||
==Classification== | ==Classification== | ||
While not universally categorized, researchers have proposed different clinical subtypes of Dercum's disease based on the distribution of painful lipomas: | While not universally categorized, researchers have proposed different clinical subtypes of Dercum's disease based on the distribution of painful lipomas: | ||
* '''Generalized diffuse''' – widespread pain in adipose tissue without clear lipomas | * '''Generalized diffuse''' – widespread pain in adipose tissue without clear lipomas | ||
* '''Generalized nodular''' – widespread pain with identifiable, painful nodules | * '''Generalized nodular''' – widespread pain with identifiable, painful nodules | ||
* '''Localized nodular''' – limited areas of painful nodules | * '''Localized nodular''' – limited areas of painful nodules | ||
* '''Juxta-articular''' – painful deposits near joints | * '''Juxta-articular''' – painful deposits near joints | ||
==Causes== | ==Causes== | ||
The exact [[etiology]] of Dercum's disease remains unknown. Several theories have been proposed, including: | The exact [[etiology]] of Dercum's disease remains unknown. Several theories have been proposed, including: | ||
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* Hormonal factors related to [[menopause]] | * Hormonal factors related to [[menopause]] | ||
* [[Trauma]] as a triggering event in some cases | * [[Trauma]] as a triggering event in some cases | ||
==Diagnosis== | ==Diagnosis== | ||
Diagnosis of | Diagnosis of Dercum’s disease is clinical and often based on exclusion. There are no definitive laboratory or imaging tests for the condition. Diagnosis is generally made based on: | ||
* Chronic [[pain]] in [[fatty tissue]] | * Chronic [[pain]] in [[fatty tissue]] | ||
* Presence of [[lipomas]] | * Presence of [[lipomas]] | ||
* Associated features such as obesity, fatigue, and emotional changes | * Associated features such as obesity, fatigue, and emotional changes | ||
* Absence of other conditions (e.g., [[lipedema]], [[fibromyalgia]], [[hypothyroidism]]) | * Absence of other conditions (e.g., [[lipedema]], [[fibromyalgia]], [[hypothyroidism]]) | ||
Imaging studies such as [[ultrasound]] or [[MRI]] may assist in identifying lipomas but are not required for diagnosis. | Imaging studies such as [[ultrasound]] or [[MRI]] may assist in identifying lipomas but are not required for diagnosis. | ||
==Differential diagnosis== | ==Differential diagnosis== | ||
Differential diagnoses include: | Differential diagnoses include: | ||
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* [[Hypothyroidism]] | * [[Hypothyroidism]] | ||
* [[Polymyalgia rheumatica]] | * [[Polymyalgia rheumatica]] | ||
==Treatment== | ==Treatment== | ||
There is no known cure for | There is no known cure for Dercum’s disease, and treatment is symptomatic. Management strategies include: | ||
===Medications=== | ===Medications=== | ||
* [[Nonsteroidal anti-inflammatory drugs]] (NSAIDs) | * [[Nonsteroidal anti-inflammatory drugs]] (NSAIDs) | ||
| Line 90: | Line 99: | ||
* [[Antidepressants]] and [[anticonvulsants]] for neuropathic pain | * [[Antidepressants]] and [[anticonvulsants]] for neuropathic pain | ||
* [[Corticosteroids]] for inflammation (limited evidence) | * [[Corticosteroids]] for inflammation (limited evidence) | ||
===Non-pharmacologic therapies=== | ===Non-pharmacologic therapies=== | ||
* [[Physical therapy]] and [[occupational therapy]] | * [[Physical therapy]] and [[occupational therapy]] | ||
* [[Psychotherapy]] or counseling for emotional symptoms | * [[Psychotherapy]] or counseling for emotional symptoms | ||
* Supportive therapies such as [[acupuncture]] or [[massage therapy]] | * Supportive therapies such as [[acupuncture]] or [[massage therapy]] | ||
===Surgical options=== | ===Surgical options=== | ||
* Excision of particularly painful lipomas | * Excision of particularly painful lipomas | ||
* [[Liposuction]] to reduce fat volume (results vary) | * [[Liposuction]] to reduce fat volume (results vary) | ||
==Prognosis== | ==Prognosis== | ||
Dercum’s disease is a chronic condition with a variable course. While it is not typically life-threatening, it can lead to significant morbidity, [[disability]], and decreased [[quality of life]]. Pain and fatigue are often persistent, and management typically requires a [[multidisciplinary]] approach. | |||
==Epidemiology== | ==Epidemiology== | ||
Dercum’s disease is considered a rare disorder. It is more common in women than men, particularly in the age range of 35 to 60 years. Exact prevalence data is lacking due to underdiagnosis and misclassification. | |||
==History== | ==History== | ||
'''Francis Xavier Dercum''' first described the condition in 1892, identifying a syndrome characterized by painful adipose deposits in obese individuals. The term | '''Francis Xavier Dercum''' first described the condition in 1892, identifying a syndrome characterized by painful adipose deposits in obese individuals. The term “Adiposis dolorosa” was originally used but has since been largely abandoned in favor of “Dercum’s disease” as understanding of related disorders has evolved. | ||
==See also== | ==See also== | ||
* [[Lipedema]] | * [[Lipedema]] | ||
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* [[Chronic pain]] | * [[Chronic pain]] | ||
* [[Obesity]] | * [[Obesity]] | ||
[[Category:Dermatology]] | [[Category:Dermatology]] | ||
[[Category:Rare diseases]] | [[Category:Rare diseases]] | ||
Latest revision as of 01:03, 6 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Dercum's disease | |
|---|---|
| |
| Synonyms | N/A |
| Pronounce | |
| Specialty | Rheumatology, Neurology |
| Symptoms | Painful lipomas, fatigue, weakness, depression |
| Complications | N/A |
| Onset | Middle age |
| Duration | Chronic |
| Types | |
| Causes | Unknown |
| Risks | |
| Diagnosis | Clinical diagnosis, imaging |
| Differential diagnosis | Lipomatosis, fibromyalgia, lipedema |
| Prevention | |
| Treatment | Pain management, surgery, weight loss |
| Medication | Analgesics, corticosteroids |
| Prognosis | Variable |
| Frequency | Rare |
| Deaths | |
Rare condition characterized by painful fatty tumors
| Dercum's disease | |
|---|---|
| Synonyms | Adiposis dolorosa (obsolete) |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Painful lipomas, obesity, fatigue, cognitive impairment, depression |
| Complications | Chronic pain, limited mobility, emotional distress |
| Onset | Typically in middle age, especially in menopausal women |
| Duration | Chronic |
| Types | |
| Causes | Unknown; possible nervous system dysfunction, trauma, or adipose abnormalities |
| Risks | Female sex, menopause |
| Diagnosis | Clinical diagnosis based on symptoms and exclusion of other conditions |
| Differential diagnosis | Lipedema, fibromyalgia, multiple symmetric lipomatosis |
| Prevention | None known |
| Treatment | Symptomatic management |
| Medication | Analgesics, antidepressants, anti-inflammatory drugs |
| Prognosis | Chronic condition with variable severity |
| Frequency | Rare |
| Deaths | Not commonly fatal |
Dercum's disease is a rare and chronic condition characterized by the presence of painful lipomas (benign fatty tumors), usually found in multiples throughout the adipose tissue of the body. The disease often coexists with obesity and is more frequently diagnosed in middle-aged women, especially those who are postmenopausal. Dercum's disease was first described in 1892 by American neurologist Francis Xavier Dercum at Jefferson Medical College.
The condition was historically referred to as Adiposis dolorosa, but this term is now considered obsolete, and Dercum’s disease is recognized as a distinct entity separate from conditions such as lipedema or multiple symmetric lipomatosis.
Signs and symptoms[edit]
The clinical presentation of Dercum’s disease is highly variable, but it typically includes a combination of the following cardinal features:
- Chronic pain in the adipose tissue
- Obesity or abnormal fat distribution
- Fatigue and muscle weakness
- Emotional instability, which may include depression, anxiety, confusion, and occasionally dementia or epilepsy
Additional signs and associated symptoms that have been reported in patients with Dercum’s disease include:
- Easy bruising
- Sleep disturbances
- Cognitive impairment, including memory and concentration issues
- Palpitations or tachycardia
- Joint pain and muscle aches
- Shortness of breath
- Constipation and bloating
- Diabetes mellitus or glucose intolerance
Due to the heterogeneity of symptoms, there is no universally accepted diagnostic criterion. However, a proposed “minimal definition” includes:
- Generalized overweight or obesity
- Chronic pain in subcutaneous fat or lipomas
Classification[edit]
While not universally categorized, researchers have proposed different clinical subtypes of Dercum's disease based on the distribution of painful lipomas:
- Generalized diffuse – widespread pain in adipose tissue without clear lipomas
- Generalized nodular – widespread pain with identifiable, painful nodules
- Localized nodular – limited areas of painful nodules
- Juxta-articular – painful deposits near joints
Causes[edit]
The exact etiology of Dercum's disease remains unknown. Several theories have been proposed, including:
- Dysfunction of the autonomic nervous system
- Inflammatory or immune-mediated abnormalities in adipose tissue
- Mechanical compression of peripheral nerves by lipomas
- Hormonal factors related to menopause
- Trauma as a triggering event in some cases
Diagnosis[edit]
Diagnosis of Dercum’s disease is clinical and often based on exclusion. There are no definitive laboratory or imaging tests for the condition. Diagnosis is generally made based on:
- Chronic pain in fatty tissue
- Presence of lipomas
- Associated features such as obesity, fatigue, and emotional changes
- Absence of other conditions (e.g., lipedema, fibromyalgia, hypothyroidism)
Imaging studies such as ultrasound or MRI may assist in identifying lipomas but are not required for diagnosis.
Differential diagnosis[edit]
Differential diagnoses include:
- Lipedema
- Fibromyalgia
- Multiple symmetric lipomatosis
- Benign symmetric lipomatosis
- Hypothyroidism
- Polymyalgia rheumatica
Treatment[edit]
There is no known cure for Dercum’s disease, and treatment is symptomatic. Management strategies include:
Medications[edit]
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Analgesics and opioids for severe pain
- Antidepressants and anticonvulsants for neuropathic pain
- Corticosteroids for inflammation (limited evidence)
Non-pharmacologic therapies[edit]
- Physical therapy and occupational therapy
- Psychotherapy or counseling for emotional symptoms
- Supportive therapies such as acupuncture or massage therapy
Surgical options[edit]
- Excision of particularly painful lipomas
- Liposuction to reduce fat volume (results vary)
Prognosis[edit]
Dercum’s disease is a chronic condition with a variable course. While it is not typically life-threatening, it can lead to significant morbidity, disability, and decreased quality of life. Pain and fatigue are often persistent, and management typically requires a multidisciplinary approach.
Epidemiology[edit]
Dercum’s disease is considered a rare disorder. It is more common in women than men, particularly in the age range of 35 to 60 years. Exact prevalence data is lacking due to underdiagnosis and misclassification.
History[edit]
Francis Xavier Dercum first described the condition in 1892, identifying a syndrome characterized by painful adipose deposits in obese individuals. The term “Adiposis dolorosa” was originally used but has since been largely abandoned in favor of “Dercum’s disease” as understanding of related disorders has evolved.
See also[edit]
