Dercum's disease

Dercum's disease is a very rare condition in which patients experience a growth of painful fat tissue. The condition is progressive and becomes worse over time. Patients with Dercum's disease may develop painful fatty lumps and nodules, called lipomas, or they may experience more diffuse pain throughout fatty tissue. The pain may be extreme and intense, the pain may be continuous (lasting for hours), or it may come and go in spasms.
Symptoms are usually first seen in adults, and the disease is less common in children and teenagers. The disease is most common in overweight postmenopausal women. However some patients who develop the disease are not obese. In general, Dercum's disease is thought to be a very rare condition.
The cause of Dercum's disease is not clear. Some evidence suggests it may be an inherited condition, but many cases have been reported that do not seem to involve genetic transmission from a parent to a child.
Currently, there is no known cure for Dercum's disease. Treatment focuses on management of symptoms, especially reduction of pain.

Postmenopausal overweight women appear to have the greatest risk for developing Dercum's disease. Only about one in 20 individuals with Dercum's disease is male. The condition has also been observed in teenagers and children, but it is not as common.

The cause of Dercum's disease is not clear. Some evidence suggests that it may be due to inheritance of a defective gene, but in many cases the disease appears to occur randomly. No gene or mutation that causes Dercum's disease has been identified.

Patients with Dercum's disease experience a growth of painful fat tissue. The condition is usually progressive and becomes worse over time.
Patients may develop painful fatty lumps and nodules, called lipomas, or they may experience more diffuse pain throughout fatty tissue. The painful fat deposits may appear almost anywhere on a patient's body. Very often, painful fat is found on the hips, the inside of the knees, the upper arms, the buttocks, the armpit, or the stomach. Rarely is it found on the face or hands.
Pain: The pain that patients with Dercum's disease experience may be extreme and intense. Pain usually increases when a lipoma is bumped or pressed. In some cases, just clothing touching the skin is enough to cause pain. Pain may be continuous, lasting for hours, or it may come and go.
Due to pain, patients with Dercum's disease may have difficulty performing everyday tasks, such as walking, driving, or lifting objects.
Fatigue: Patients with Dercum's disease often experience fatigue and a loss of strength.
Mental problems: Some mild mental disturbances, including depression, confusion, and memory problems have been reported by patients with Dercum's disease. Some patients may have headaches or difficulty sleeping.

Dercum's disease is very rare and difficult to diagnose, and there are no tests that can be used to conclusively diagnose the condition.
Some patients may find that Dercum's disease is not well known or accepted in the medical field. In some instances, doctors have assumed that the symptoms are imaginary.
Typically, a diagnosis of Dercum's disease may be made when a patient experiences at least three months of chronic pain in fatty tissue.

Swelling: For unclear reasons, patients with Dercum's disease may experience swelling of the skin, which can cause the skin to become loose and inelastic.
Numbness: In some instances, patients may experience numbness or a burning sensation in a limb, especially the hands or feet. This is usually caused by a lipoma that is pressing against a nerve.
Impaired heart/lung function: Lipomas may move to the heart or to the lungs and interfere with cardiac or pulmonary function. Although this occurs very rarely, it may lead to a potentially life-threatening situation.

Currently, there is no known cure for Dercum's disease. Treatment focuses on management of symptoms, especially reduction of pain.
Drugs: Many drugs commonly used to relieve pain (such as analgesics like NSAIDs or acetaminophen) do not appear to be effective in treating Dercum's disease.
Lidocaine: One drug that has been used to treat Dercum's disease effectively is lidocaine, which is commonly used as an anesthetic. Patients receiving lidocaine intravenously over a 30-90 minute period have reported relief from pain lasting several weeks. Additionally, lidocaine has been administered using a patch. Side effects of lidocaine may include a drop in blood pressure, abnormal heart rhythms, dizziness, or headache.
Surgery: Surgical removal of lipomas usually is effective in reducing pain for a patient. However, surgery is not considered a cure, as lipomas often grow back after being removed.
Liposuction: Liposuction (a surgical procedure used to remove fat from the body) may be used to treat Dercum's disease. Removal of fat often leads to a reduction in pain in patients and an improved quality of life.

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