Adiposis Dolorosa (Dercum’s Disease): Causes, Symptoms, Diagnosis, and Treatment
What is Adiposis Dolorosa (Dercum’s Disease)?
Adiposis Dolorosa, also known as Dercum’s Disease, is a rare disorder characterized by painful fatty tumors (lipomas) that develop under the skin. These growths are most commonly found on the trunk, upper arms, and thighs and cause chronic pain, fatigue, and other systemic symptoms.
The exact cause of Dercum’s Disease is unknown, but it is believed to involve abnormal fat metabolism, inflammation, and nervous system dysfunction. It is more common in women (especially after menopause) and is often progressive over time.
What Causes Dercum’s Disease?
The exact cause is unknown, but potential factors include:
✔ Genetic predisposition – Some cases run in families
✔ Metabolic dysfunction – Possible link to obesity and hormonal imbalances
✔ Neurological involvement – Nerve dysfunction may contribute to pain
✔ Autoimmune disorders – Some patients have immune system abnormalities
Who is at Risk for Dercum’s Disease?
✔ Middle-aged women (especially postmenopausal)
✔ People with a family history of the disease
✔ Individuals with obesity or metabolic disorders
What Are the Symptoms of Dercum’s Disease?
The primary symptom is painful lipomas, but other systemic symptoms can also occur.
Common Symptoms:
✔ Painful fatty tumors (lipomas) – Soft, movable lumps under the skin
✔ Chronic pain – Ranging from mild discomfort to severe pain
✔ Fatigue and weakness
✔ Weight gain (unrelated to diet or lifestyle changes)
Other Possible Symptoms:
✔ Cognitive issues (brain fog, memory problems)
✔ Depression, anxiety, or mood changes
✔ Swelling (edema) in the affected areas
✔ Sleep disturbances
✔ Bruising easily
How is Dercum’s Disease Diagnosed?
Diagnosis is clinical, meaning it is based on symptoms and physical examination.
✔ Medical History & Physical Exam – Identifying painful lipomas and ruling out other conditions
✔ Imaging Tests (Ultrasound, MRI, CT scan) – Helps visualize lipomas
✔ Biopsy (if needed) – To rule out cancerous growths
✔ Blood Tests – To check for metabolic or autoimmune disorders
What Are the Treatment Options for Dercum’s Disease?
There is no cure, but treatment focuses on pain management and symptom relief.
1. Pain Management
✔ Pain relievers (NSAIDs, acetaminophen, or stronger pain medications)
✔ Neuropathic pain medications (Gabapentin, Pregabalin)
✔ Corticosteroid injections – To reduce inflammation in painful areas
2. Lipoma Removal
✔ Liposuction – Minimally invasive fat removal
✔ Surgical excision – Removing individual lipomas for severe cases
3. Lifestyle and Supportive Therapies
✔ Weight management – May reduce symptoms in some cases
✔ Physical therapy and gentle exercise – Helps maintain mobility
✔ Compression garments – May help with swelling and pain
✔ Psychological support – Counseling for depression and anxiety
4. Experimental Treatments
✔ Lymphatic drainage therapy – Helps with swelling
✔ Electrotherapy (TENS units) – May help with pain relief
✔ Ketogenic or anti-inflammatory diets – Some patients report symptom improvement
What is the Prognosis for Dercum’s Disease?
✔ Chronic condition with no known cure
✔ Symptoms can worsen over time
✔ Pain management and lifestyle adjustments can improve quality of life
✔ Not life-threatening but can significantly impact daily activities
Can Dercum’s Disease Be Prevented?
✔ No known prevention, as the cause is unclear
✔ Managing weight and metabolic health may help reduce symptom severity