Thermal and vibratory thresholds after liposuction in patients with Dercum's disease

Hansson, Emma; Svensson, Henry; Rosén, Ingmar; Brorson, Håkan

doi:10.3109/2000656x.2011.561102

Cited by 5 publications

(4 citation statements)

References 23 publications

(27 reference statements)

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“…Different mechanisms have been suggested for the local sensitivity loss, even though the main theory concerns direct nerve trauma caused by the cannula. However, in a previous study, we have demonstrated that thermal and vibratory thresholds do not differ after liposuction in patients with Dercum's disease [22]. It is unlikely that direct nerve destruction alone explain the pain reduction seen in our patients following liposuction.…”

Section: Resultscontrasting

confidence: 48%

Liposuction May Reduce Pain in Dercum's Disease (Adiposis Dolorosa)

2011

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Section: Resultscontrasting

confidence: 48%

Liposuction May Reduce Pain in Dercum's Disease (Adiposis Dolorosa)

2011

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“…Reduction of altered fat masses seems to be the main cause of pain reduction because pain diminution lasted longer than sensitivity loss after liposuction [36]. There was no significant difference in thermal and vibratory thresholds 3 and 12 months after liposuction in patients with Dercum’s disease [37]. Liposuction was also applied in cases of juxta-articular form of the disease [38].…”

Section: Treatmentmentioning

confidence: 99%

Dercum’s disease (adiposis dolorosa): a review of clinical presentation and management

Kucharz¹,

Kopeć-Mędrek²,

Kramza³

et al. 2019

Reumatologia

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Dercum's disease (adiposis dolorosa) is a rare disease of unknown etiology characterized by painful subcutaneous adipose tissue deposits with various localization over the body. The deposits occur histologically as lipomas and are associated with overweight or obesity and a variety of psychiatric disturbances (anxiety, depression, sleep disturbances). Classification of Dercum's disease is related to size and location of adipose nodules (generalized diffuse, generalized nodular, localized nodular and juxta-articular forms). Diagnosis in based on clinical presentation and exclusion of a number of other disorders associated with lipomas. There is no generally accepted management of the patients. Liposuction or lidocaine application has been reported successful in some cases. Other therapeutic methods have been reported but their effectiveness is based on anecdotal descriptions only, and were not confirmed in clinical trials.

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“…Based on our review of the literature and studies on 111 patients with Dercum’s disease [46-48] we propose that Dercum’s disease should be classified into (Table 1):…”

Section: Classificationmentioning

confidence: 99%

“…The mechanism behind pain relief following liposuction is thought to be that nerve plexuses in the adipose tissue are destroyed [57]. However, it is unlikely that direct nerve destruction alone explains the pain reduction seen following liposuction [48]. Furthermore, the reduction in pain in Dercum’s disease persisted longer than sensitivity loss normally seems to persist after liposuction in healthy patients [46].…”

Section: Management Including Treatmentmentioning

confidence: 99%

Review of Dercum’s disease and proposal of diagnostic criteria, diagnostic methods, classification and management

Hansson

Svensson

Brorson

2012

Orphanet J Rare Dis

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105

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Definition and clinical picture: We propose the minimal definition of Dercum's disease to be generalised overweight or obesity in combination with painful adipose tissue. The associated symptoms in Dercum's disease include fatty deposits, easy bruisability, sleep disturbances, impaired memory, depression, difficulty concentrating, anxiety, rapid heartbeat, shortness of breath, diabetes, bloating, constipation, fatigue, weakness and joint aches. Classification:We suggest that Dercum's disease is classified into: I. Generalised diffuse form A form with diffusely widespread painful adipose tissue without clear lipomas, II. Generalised nodular form -a form with general pain in adipose tissue and intense pain in and around multiple lipomas, and III. Localised nodular form -a form with pain in and around multiple lipomas IV. Juxtaarticular form -a form with solitary deposits of excess fat for example at the medial aspect of the knee.Epidemiology: Dercum's disease most commonly appears between the ages of 35 and 50 years and is five to thirty times more common in women than in men. The prevalence of Dercum's disease has not yet been exactly established.Aetiology: Proposed, but unconfirmed aetiologies include: nervous system dysfunction, mechanical pressure on nerves, adipose tissue dysfunction and trauma. Diagnosis and diagnostic methods: Diagnosis is based on clinical criteria and should be made by systematic physical examination and thorough exclusion of differential diagnoses. Advisably, the diagnosis should be made by a physician with a broad experience of patients with painful conditions and knowledge of family medicine, internal medicine or pain management. The diagnosis should only be made when the differential diagnoses have been excluded. Differential diagnosis: Differential diagnoses include: fibromyalgia, lipoedema, panniculitis, endocrine disorders, primary psychiatric disorders, multiple symmetric lipomatosis, familial multiple lipomatosis, and adipose tissue tumours. Genetic counselling: The majority of the cases of Dercum's disease occur sporadically. A to G mutation at position A8344 of mitochondrial DNA cannot be detected in patients with Dercum's disease. HLA (human leukocyte antigen) typing has not revealed any correlation between typical antigens and the presence of the condition. Management and treatment: The following treatments have lead to some pain reduction in patients with Dercum's disease: Liposuction, analgesics, lidocaine, methotrexate and infliximab, interferon α-2b, corticosteroids, calcium-channel modulators and rapid cycling hypobaric pressure. As none of the treatments have led to long lasting complete pain reduction and revolutionary results, we propose that Dercum's disease should be treated in multidisciplinary teams specialised in chronic pain. Prognosis: The pain in Dercum's disease seems to be relatively constant over time.

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Thermal and vibratory thresholds after liposuction in patients with Dercum's disease

Cited by 5 publications

References 23 publications

Liposuction May Reduce Pain in Dercum's Disease (Adiposis Dolorosa)

Liposuction May Reduce Pain in Dercum's Disease (Adiposis Dolorosa)

Dercum’s disease (adiposis dolorosa): a review of clinical presentation and management

Review of Dercum’s disease and proposal of diagnostic criteria, diagnostic methods, classification and management

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