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Joint Bone Spine Oct 2018
Topics: Adiposis Dolorosa; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Arthritis, Rheumatoid; Female; Humans; Knee Joint; Middle Aged; Rare Diseases; Risk Assessment; Severity of Illness Index
PubMed: 29198885
DOI: 10.1016/j.jbspin.2017.11.012 -
Giornale Italiano Di Dermatologia E... Dec 2017
Topics: Adiposis Dolorosa; Adult; Diagnosis, Differential; Familial Multiple Lipomatosis; Female; Humans; Lipomatosis, Multiple Symmetrical; Male; Middle Aged; Skin Diseases
PubMed: 29050453
DOI: 10.23736/S0392-0488.16.05410-9 -
European Journal of Internal Medicine Dec 2017
Topics: Adiposis Dolorosa; Arthritis, Rheumatoid; Female; Humans; Middle Aged; Pain
PubMed: 28479013
DOI: 10.1016/j.ejim.2017.04.022 -
Journal of Neurology Apr 2017
Topics: Adiposis Dolorosa; Brain; Family Health; Female; Humans; Magnetic Resonance Imaging; Middle Aged; Nervous System Diseases
PubMed: 28194532
DOI: 10.1007/s00415-017-8415-1 -
International Journal of Obesity (2005) Feb 2017People with lipedema or Dercum's disease (DD) can have a similar distribution of excess painful nodular subcutaneous adipose tissue (SAT), making them difficult to...
BACKGROUND
People with lipedema or Dercum's disease (DD) can have a similar distribution of excess painful nodular subcutaneous adipose tissue (SAT), making them difficult to differentiate.
METHODS
Case series of 94 patients with DD, 160 with lipedema and 18 with both diagnoses (Lip+DD) from a single clinic in an academic medical center to improve identification and differentiation of these disorders by comparison of clinical findings, prevalence of type 2 diabetes (DM2), hypermobility by the Beighton score and assessment of a marker of inflammation, Total complement activity (CH50).
RESULTS
Differences between groups were by Student's t-test with α of 0.05. The Lipedema Group had significantly greater weight, body mass index (BMI), gynoid distributed nodular SAT and fibrotic and heavy tissue than the DD Group. Hypermobility was significantly higher in the Lipedema (58±0.5%) than DD Group (23±0.4%; P<0.0001). DM2 was significantly greater in the DD (16±0.2%; P=0.0007) than the Lipedema Group (6±0.2%). Average pain by an analog scale was significantly higher in the DD (6±2.5%) than the Lipedema Group (4±2.1%; P<0.0001). Fatigue and swelling were common in both groups. Easy bruising was more common in the Lipedema Group, whereas abdominal pain, shortness of breath, fibromyalgia, migraines and lipomas were more prevalent in the DD Group. The percentage of patients with elevated CH50 was significantly positive in both groups.
CONCLUSIONS
The significantly lower prevalence of DM2 in people with lipedema compared with DD may be due to the greater amount of gynoid fat known to be protective against metabolic disorders. The high percentage of hypermobility in lipedema patients indicates that it may be a comorbid condition. The location of fat, high average daily pain, presence of lipomas and comorbid painful disorders in DD patients may help differentiate from lipedema.
Topics: Adiposis Dolorosa; Diabetes Mellitus, Type 2; Diagnosis, Differential; Female; Humans; Lipedema; Magnetic Resonance Imaging; Male; Middle Aged; Pain; Pain Measurement; Practice Guidelines as Topic; Subcutaneous Fat
PubMed: 27857136
DOI: 10.1038/ijo.2016.205 -
Plastic and Reconstructive Surgery.... Sep 2016Lipedema, or adiposis dolorosa, is a common adipose tissue disorder that is believed to affect nearly 11% of adult women worldwide. It is characterized most commonly by...
Lipedema, or adiposis dolorosa, is a common adipose tissue disorder that is believed to affect nearly 11% of adult women worldwide. It is characterized most commonly by disproportionate adipocyte hypertrophy of the lower extremities, significant tenderness to palpation, and a failure to respond to extreme weight loss modalities. Women with lipedema report a rapid growth of the lipedema subcutaneous adipose tissue in the setting of stress, surgery, and/or hormonal changes. Women with later stages of lipedema have a classic "column leg" appearance, with masses of nodular fat, easy bruising, and pain. Despite this relatively common disease, there are few physicians who are aware of it. As a result, patients are often misdiagnosed with lifestyle-induced obesity, and/or lymphedema, and subjected to unnecessary medical interventions and fat-shaming. Diagnosis is largely clinical and based on criteria initially established in 1951. Treatment of lipedema is effective and includes lymphatic support, such as complete decongestive therapy, and specialized suction lipectomy to spare injury to lymphatic channels and remove the diseased lipedema fat. With an incidence that may affect nearly 1 in 9 adult women, it is important to generate appropriate awareness, conduct additional research, and identify better diagnostic and treatment modalities for lipedema so these women can obtain the care that they need and deserve.
PubMed: 27757353
DOI: 10.1097/GOX.0000000000001043 -
Endocrine Practice : Official Journal... Aug 2016
Topics: Adiposis Dolorosa; Facial Nerve Diseases; Humans; Male; Middle Aged; Temporal Muscle
PubMed: 26919646
DOI: 10.4158/EP161236.VV -
Wiener Medizinische Wochenschrift (1946) Sep 2015Juxta-articular adiposis dolorosa is a rare subtype of Dercum's disease. It manifests mainly on the medial parts of the knees. Pain and impaired mobility are common...
Juxta-articular adiposis dolorosa is a rare subtype of Dercum's disease. It manifests mainly on the medial parts of the knees. Pain and impaired mobility are common symptoms. We report on four females (aged between 52 and 83 years) who suffered from juxta-articular adiposis dolorosa for more than 10 years. These patients were successfully treated by dermolipectomy resulting in dramatically improved pain and mobility. Adverse effects and complications were minor with a lymph fistula in a single patient which was treated by surgery.
Topics: Adiposis Dolorosa; Aged; Aged, 80 and over; Cutaneous Fistula; Female; Fistula; Humans; Lipectomy; Lymphatic Diseases; Middle Aged; Mobility Limitation; Pain Measurement; Postoperative Complications; Reoperation
PubMed: 26289595
DOI: 10.1007/s10354-015-0378-1 -
Medicine Jun 2015Dercum's disease is a rare condition of painful subcutaneous growth of adipose tissue. Etiology is unknown and pain is difficult to control. We report the case of a...
Dercum's disease is a rare condition of painful subcutaneous growth of adipose tissue. Etiology is unknown and pain is difficult to control. We report the case of a 57-year-old man with generalized diffuse Dercum's disease, who improved after the treatment with transcutaneous frequency rhythmic electrical modulation system (FREMS). Treatment consisted in 4 cycles of 30 minutes FREMS sessions over a 6-month period. Measures of efficacy included pain assessment (visual analogue scale, VAS), adipose tissue thickness by magnetic resonance imaging, total body composition and regional fat mass by dual-energy X-ray absorptiometry, physical disability (Barthel index), and health status (Short Form-36 questionnaire). After FREMS treatment the patient's clinical conditions significantly improved, with reduction of pain on the VAS scale from 64 to 17 points, improvement of daily life abilities (the Barthel index increased from 12 to 18) and amelioration of health status (higher scores than baseline in all Short Form-36 domains). Furthermore, we documented a 12 mm reduction in subcutaneous adipose tissue thickness at the abdominal wall and a 7040 g decrease in total body fat mass. FREMS therapy proved to be effective and safe in the treatment of this rare and disabling condition.
Topics: Adipose Tissue; Adiposis Dolorosa; Body Composition; Body Mass Index; Disability Evaluation; Electric Stimulation Therapy; Health Status; Humans; Male; Middle Aged
PubMed: 26091459
DOI: 10.1097/MD.0000000000000950 -
Skeletal Radiology Jun 2015Adiposis dolorosa (Dercum's disease) is a condition of benign, painful subcutaneous lipomatous lesions associated with weakness, endocrine and lipid abnormalities, and...
PURPOSE
Adiposis dolorosa (Dercum's disease) is a condition of benign, painful subcutaneous lipomatous lesions associated with weakness, endocrine and lipid abnormalities, and mental disturbances. There is little information documenting the cross-sectional imaging findings that differentiate it from lipomatous and neoplastic soft tissue masses, or massive localized lymphedema. The purpose of this study was to provide a radiological case series of adiposis dolorosa.
METHODS
A 10-year retrospective review of the picture archiving and communications system was performed. Two musculoskeletal radiologists reviewed images to confirm and document imaging features, location, size, and patient demographics. Medical records were reviewed to characterize patients into three groups: one group met at least three of the four criteria of Dercum's syndrome, the second group met less than three criteria, and the third group had clinical diagnosis of cellulitis of the lower extremity.
RESULTS
Seventeen cases (25 masses) of adiposis dolorosa were found, nine cases of which met at least three criteria of Dercum's syndrome. All cases in the first two groups demonstrated skin thickening and lymphedema of subcutaneous fat, which was fluid attenuation on CT and low or intermediate T1-weighted and high STIR/T2-weighted MR signal. Two cases with pathology showed mild fatty infiltration with fibrous septa, and the third case showed massive localized lymphedema. The third group of ten cellulitis patients demonstrated non-mass-like subcutaneous edema with similar CT attenuation and MR signal characteristics to the first two groups, but differed by the presence of post-contrast enhancement and non-mass-like appearance in 90%.
CONCLUSION
Imaging findings of adiposis dolorosa and massive localized lymphedema overlap, as do the symptoms and pathological features. Due to the mass-like engorgement of the soft tissues and pain, patients will often undergo imaging to exclude neoplasm or infection. Knowledge of these conditions and the characteristic imaging findings is important to prevent unnecessary biopsy and misdiagnosis.
Topics: Adiposis Dolorosa; Adult; Aged; Diagnosis, Differential; Female; Humans; Lymphedema; Magnetic Resonance Imaging; Male; Middle Aged; Observer Variation; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 25672948
DOI: 10.1007/s00256-015-2114-8