What is Dercum's disease?
Dercum's disease is also known as adipositas dolorosa and describes a very rare chronic form of obesity. The disease differs from normal obesity in terms of the nature and painfulness of the fat tissue. In Dercum's disease, painful fatty tissue deposits, called lipomas, form in the subcutaneous connective tissue. If these persist for at least three months, it is usually called Dercum's disease. In this disease, the legs and arms, but also the trunk area, the pelvic region and the buttocks are predominantly affected.
Women between the ages of 25 and 40 are more likely than average to develop the disease, and many patients already come from an obese family. Alcoholism is also often considered a cause of Decrum's disease. So far, medical knowledge about the exact causes of the disease and a suitable treatment method is still incompletely clarified. That is why the treatment of Decrum's disease tends to be pain management.
What are the causes of Dercum's disease?
The causes of Dercum's disease are still unknown. However, doctors assume that the disease develops due to a genetic disposition. In addition, immunological processes as well as a disturbance in the synthesis of C18 fatty acids, thyroid disorders and/or the dysregulation of the nervous system may also play a role in the cause of the disease. So far, there are no convincing scientific studies to prove these theories, as it is a very rare clinical picture.
What are the different forms of Dercum's disease?
Dercum's disease can be divided into the following three types:
- Type I: so-called juxtaarticular type, which is associated with painful fat pads on the hips or knees.
- Type II: so-called diffuse, generalised type, which is associated with the formation of painful fatty tissue in different parts of the body.
- Type III: so-called nodular type, also called lipomatosis, which is associated with the formation of painful lipomas with or without concomitant obesity (adiposity).
How can Dercum's disease be prevented?
Suitable preventive measures to prevent the disease do not exist. However, overweight should be avoided.
What are the symptoms of Dercum's disease?
Many patients suffering from Dercum's disease are obese. However, the disease can also affect people of normal weight. Typical signs of Dercum's disease are subcutaneous deposits of fatty tissue. These manifest themselves predominantly on the following parts of the body:
- the inside of the upper arm,
- the outer and inner side of the thigh,
- the elbows,
- the knees,
- the abdomen,
- on the buttocks
Those affected complain of stabbing or burning pains that occur even with slight pressure on the fat deposits. Doctors call this hyperalgesia. Over time, this pain can increase in intensity and significantly reduce the patient's quality of life.
When should a doctor be consulted because of the complaints?
Pain in the fatty tissue can indicate Dercum's disease and should be clarified quickly by a doctor. However, medical advice is needed at the latest when the growing fatty tissue leads to restrictions in the musculoskeletal system or other complaints. Often patients can also develop psychological complaints due to their condition, which should be accompanied by a therapist. Ideally, the therapist is in close contact with the treating doctor.
How is Dercum's disease diagnosed?
Dercum's disease is usually diagnosed by means of a fine-tissue examination of the fatty tissue. In some cases, a magnetic resonance imaging (MRI) scan can also be performed, which can provide diagnostic information about the disease. The diagnosis is made by the general practitioner or specialist.
How is Dercum's disease treated?
The treatment of Dercum's disease is still very unsatisfactory and is mostly purely symptomatic, i.e. combating the symptoms. For example, the pain-relieving drug analgesic is prescribed. An infusion with the anaesthetic lidocaine is also possible. This usually leads to the patient remaining pain-free for days or weeks, in some cases even for months. However, as this therapy has some side effects, it cannot be used permanently. Alternatively, lidocaine patches or creams in a weakened form can also bring about a reduction in pain.
Instead of medication, the patient can also resort to liposuction or surgical removal of the fatty tissue (excision). However, both of these procedures carry a high risk of recurrence (high relapse rate). Dercum's disease is treated by a specialist whose speciality is diseases of the fatty tissue. The individual symptoms of the disease can be treated by different specialists, such as gastroenterologists or dermatologists. For a healthier lifestyle and dietary changes to reduce weight, a nutritionist should be consulted.
As Dercum's disease is a chronic condition, the patient needs lifelong treatment. In many cases, psychological therapy is also necessary, as patients not only suffer from sometimes extreme pain, but also know that their disease cannot be cured.
What are the risks of Decrum's disease?
Due to an extreme accumulation of fatty tissue, Decrum's disease can lead to restrictions in mobility, but also to joint problems. Many patients also suffer from sleep disorders, impaired memory or concentration, depression or anxiety. Rather rarely, it can also lead to a faster heartbeat accompanied by shortness of breath, the development of diabetes and muscle weakness or pain.