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Tumori 2008Among the symptoms reported by patients undergoing breast imaging, pain is one of the most common. Mastalgia is generally classified as cyclic, noncyclic, or...
Among the symptoms reported by patients undergoing breast imaging, pain is one of the most common. Mastalgia is generally classified as cyclic, noncyclic, or extramammary. A rare cause of breast pain is Dercum's disease, or adiposis dolorosa, a condition characterized by multiple, often painful subcutaneous lipomas. Painful breast lipomas have not been described in the literature so far. The diagnosis is made by clinical means supported by diagnostic imaging. We report the case of a 58-year-old postmenopausal woman affected by Dercum's disease in the breast. Ultrasound examination showed multiple oval, well-defined, hyperechoic lesions suggestive of breast lipomas. No significant features were detected by mammography.
Topics: Adiposis Dolorosa; Breast Diseases; Diagnosis, Differential; Female; Humans; Lipoma; Mammography; Middle Aged; Pain; Ultrasonography, Mammary
PubMed: 19112957
DOI: 10.1177/030089160809400523 -
International Journal of Obesity (2005) Sep 2009Adiposis dolorosa (AD) is a syndrome of obese and non-obese individuals whose hallmark is lipomatosis: unencapsulated painful fatty masses in subcutaneous fat....
BACKGROUND
Adiposis dolorosa (AD) is a syndrome of obese and non-obese individuals whose hallmark is lipomatosis: unencapsulated painful fatty masses in subcutaneous fat. Lipomatosis may contain excess collagen and multi-nucleated giant (MNG) cells. Case reports suggest metabolic defects in AD.
OBJECTIVES
(1) To determine whether women with AD have altered relative resting energy expenditure (REE per total body mass) compared with controls; and (2) to quantitate lipomatosis-associated collagen, MNGs and tissue and blood cytokines that may influence REE.
METHODS
A total of 10 women with AD were compared with age, body mass index, fat and weight-matched control women. Adipose tissue was obtained from five women with AD and five controls and evaluated for collagen and macrophages/MNGs. Fat mass and fat-free mass were identified by dual X-ray absorptiometry. REE was by determined indirect calorimetry and related to mass. Adipokines and cytokines were evaluated in blood and tissue.
RESULTS
Relative REE (REE per total body mass) was lower in women with AD compared with controls (P=0.007). Only lipomatosis (group) and total body mass were significant predictors of REE in forward stepwise regression (P<0.0001). Adipose interleukin (IL)-6 levels were elevated (P=0.03) and connective tissue was increased fourfold in lipomatosis compared with control tissue (P <0.0001). There was no difference in adipose tissue macrophages between groups; 30% of women with AD had MNG cells. Anti-inflammatory IL-13 levels were elevated (P=0.03), and cytokines important in the recruitment of monocytes, Fraktalkine (P=0.04) and macrophage inflammatory protein-1beta (P=0.009), were significantly lower in the blood of women with AD compared with controls.
CONCLUSIONS
The lower relative REE in women with AD compared with controls was associated with increased connective (non-metabolic) tissue in the lipomatosis, and inflammation, although underlying metabolic defects may be important as well. Understanding the pathophysiology and metabolism of lipomatosis in AD may contribute to a better understanding of metabolism in non-lipomatosis obesity.
Topics: Absorptiometry, Photon; Adipokines; Adipose Tissue; Adiposis Dolorosa; Adolescent; Adult; Basal Metabolism; Calorimetry, Indirect; Case-Control Studies; Collagen; Cytokines; Energy Metabolism; Female; Giant Cells; Humans; Inflammation Mediators; Lipomatosis; Middle Aged; Rest; Young Adult
PubMed: 19621017
DOI: 10.1038/ijo.2009.119 -
Skeletal Radiology May 2020We report a case of a 70-year-old woman with a BMI of 58 who developed cellulitis refractory to treatment, within an area of massive localized lymphedema. Biopsy showed...
We report a case of a 70-year-old woman with a BMI of 58 who developed cellulitis refractory to treatment, within an area of massive localized lymphedema. Biopsy showed angiosarcoma. MRI showed multiple lobulated, low T1, high T2 masses within a background of prominent soft tissue septal stranding, dilated lymphatic channels, and skin thickening. CT also showed the mass well, within the background lymphedema. Massive localized lymphedema is increasing in prevalence due to the worsening obesity epidemic. Radiologists should be aware that the presence of a nodule within an area of massive localized lymphedema is suspicious for sarcoma.
Topics: Aged; Biopsy; Diagnosis, Differential; Female; Hemangiosarcoma; Humans; Lymphedema; Magnetic Resonance Imaging; Soft Tissue Neoplasms; Thigh; Tomography, X-Ray Computed
PubMed: 31950200
DOI: 10.1007/s00256-020-03373-4 -
Praxis Jan 2002The adiposis dolorosa (Dercum's disease) was described already in 1892. Many questions about its physiopathological mechanism are still unresolved. Presentation of a...
The adiposis dolorosa (Dercum's disease) was described already in 1892. Many questions about its physiopathological mechanism are still unresolved. Presentation of a patient with this disease is reported, followed by a brief review of the literature, where the pathogenesis, the differential diagnosis and the therapeutical approaches of this syndrome are especially pointed out.
Topics: Adiposis Dolorosa; Adrenal Cortex Hormones; Aged; Anesthetics, Local; Diagnosis, Differential; Female; Humans; Lidocaine; Lipectomy; Time Factors
PubMed: 11851038
DOI: 10.1024/0369-8394.91.4.129 -
West London Medical Journal Apr 1946
Topics: Adiposis Dolorosa; Humans
PubMed: 20984160
DOI: No ID Found -
Journal of the American Academy of... Jun 2007Obesity is widely recognized as an epidemic in the Western world; however, the impact of obesity on the skin has received minimal attention. The purpose of this article... (Review)
Review
UNLABELLED
Obesity is widely recognized as an epidemic in the Western world; however, the impact of obesity on the skin has received minimal attention. The purpose of this article is to highlight the association between obesity and dermatologic conditions. We review the impact of obesity on the skin, including skin physiology, skin manifestations of obesity, and dermatologic diseases aggravated by obesity. Obesity is responsible for changes in skin barrier function, sebaceous glands and sebum production, sweat glands, lymphatics, collagen structure and function, wound healing, microcirculation and macrocirculation, and subcutaneous fat. Moreover, obesity is implicated in a wide spectrum of dermatologic diseases, including acanthosis nigricans, acrochordons, keratosis pilaris, hyperandrogenism and hirsutism, striae distensae, adiposis dolorosa, and fat redistribution, lymphedema, chronic venous insufficiency, plantar hyperkeratosis, cellulitis, skin infections, hidradenitis suppurativa, psoriasis, insulin resistance syndrome, and tophaceous gout. We review the clinical features, evidence for association with obesity, and management of these various dermatoses and highlight the profound impact of obesity in clinical dermatology.
LEARNING OBJECTIVE
After completing this learning activity, participants should be aware of obesity-associated changes in skin physiology, skin manifestations of obesity, and dermatologic diseases aggravated by obesity, and be able to formulate a pathophysiology-based treatment strategy for obesity-associated dermatoses.
Topics: Acanthosis Nigricans; Adiposis Dolorosa; Animals; Chronic Disease; Comorbidity; Elasticity; Fasciitis, Necrotizing; Hidradenitis Suppurativa; Humans; Insulin Resistance; Intertrigo; Lymphedema; Microcirculation; Obesity; Pro-Opiomelanocortin; Psoriasis; Sebaceous Glands; Skin Diseases; Venous Insufficiency
PubMed: 17504714
DOI: 10.1016/j.jaad.2006.12.004 -
Schmerz (Berlin, Germany) Mar 1991
PubMed: 18415157
DOI: 10.1007/BF02529665 -
Clinical and Experimental Dermatology May 1999
Topics: Adiposis Dolorosa; Anesthetics, Local; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Infusions, Intravenous; Lidocaine; Middle Aged; Pain; Pain Measurement; Treatment Outcome
PubMed: 10354189
DOI: 10.1046/j.1365-2230.1999.00466.x -
Journal of the European Academy of... May 2007
Topics: Adiposis Dolorosa; Antibodies, Monoclonal; Dermatologic Agents; Female; Humans; Infliximab; Methotrexate; Middle Aged
PubMed: 17448013
DOI: 10.1111/j.1468-3083.2006.02021.x -
Annals of the Rheumatic Diseases Jun 1990Two patients are presented who had symptomatic relief of juxta-articular adiposis dolorosa of the knees after liposuction. Liposuction is recommended for the treatment...
Two patients are presented who had symptomatic relief of juxta-articular adiposis dolorosa of the knees after liposuction. Liposuction is recommended for the treatment of this condition.
Topics: Adiposis Dolorosa; Aged; Aged, 80 and over; Female; Humans; Knee Joint; Lipectomy
PubMed: 2383065
DOI: 10.1136/ard.49.6.403