Adiposis Dolorosa (also called Dercum disease)

Dercum's disease, known as adiposis dolorosa, was first documented in the late 19th century by the US neurologist Francis Xavier Dercum.

• Dercum's disease
• Lipomatosis dolorosa
• Morbus Dercum
• Fatty tissue rheumatism
• Ander's syndrome
• Adiposalgia

Adiposis dolorosa is characterised by multiple, painful subcutaneous lipomas or painful fatty tissue. Obese women between 35 and 50 years of age are particularly affected.

Mainly overweight women in the age range of 35 to 50 years are affected. The exact prevalence is not clear, but women are 5 to 30 times more likely to be affected than men

There are four main types:

1. Generalised diffuse form: Extensive regions of pain in adipose tissue without obvious lipomas.
2. Generalised nodular form: pain points in adipose tissue and around multiple lipomas.
3. Localised nodular form: pain points around some lipomas.
4. Juxta-articular form: An area of fatty tissue near a joint, e.g. within the knee.

The exact cause and development is not clear. Some studies point to disturbances in fatty acid metabolism or insulin resistance. There are also assumptions of an autoimmune process, problems of the nervous system or inflammatory reactions.

Main features are pain and paraesthesia in the area of the lipoma. The intensity of the pain often increases with the BMI. Accompanying symptoms can be, for example, sleep problems, memory loss, concentration problems or depression. Onset can be sudden or gradual between the ages of 35 and 50.

Diagnosis is strongly based on clinical examination, especially palpation of painful nodules. Imaging techniques such as ultrasound or MRI can be supportive. Specific laboratory tests do not exist.

There is currently no set treatment plan. Most treatments target the symptoms, such as pain relief through medication or weight loss. Some patients find relief through liposuction or surgical removal of painful areas of fat tissue.

The disease is chronic but not fatal. The course of the disease can vary, with some patients experiencing an increase in symptoms while others report improvement.

Due to the unknown aetiology, there are no specific preventive measures.

• Cook JC, Gross GP. Adiposis dolorosa. StatPearls
• Kniffin CL, McKusick VA. % 103200: Adiposis dolorosa. OMIM
• National Organization for Rare Disorders. Dercum's disease. NORD