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Year : 2000  |  Volume : 66  |  Issue : 2  |  Page : 101-102

Adiposis dolorosa

Correspondence Address:
Adarsh Chopra

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Source of Support: None, Conflict of Interest: None

PMID: 20877043

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Adiposis dolorosa, a rare condition characterised by painful subcutaneous plaques of fat as­sociated with obesity and emotional disturbances in menopausal females, is being reported

Keywords: Adiposis dolorosa, Menopausal

How to cite this article:
Chopra A, Walia P, Chopra D, Jassal. Adiposis dolorosa. Indian J Dermatol Venereol Leprol 2000;66:101-2

How to cite this URL:
Chopra A, Walia P, Chopra D, Jassal. Adiposis dolorosa. Indian J Dermatol Venereol Leprol [serial online] 2000 [cited 2020 May 30];66:101-2. Available from: http://www.ijdvl.com/text.asp?2000/66/2/101/4885

  Introduction Top

Adiposis dolorosa, coined by Dercum in 1892, is a rare disease of subcutaneous fat characterized by localized overgrowth of fat with painful subcuta­neous plaques and ecchymoses. [1] It is commonly seen in menopausal obese females and is often associ­ated with fatigue, weakness and severe emotional disturbances. [2] The fat deposits give 'bag of worms' feel on palpation. The lesions may be localized or generalized, can occur anywhere but most common sites are the juxta articular areas. Pain occurs spon­taneously or on pressure in cyclical pattern. Patient may lose weight and become asthenic as the dis­ease progresses. [3] The disease does not respond to routine analgesics but only to I/V lidocain. [4] Histopa­thology is indistinguishable from ordinary lipoma showing mature adipocytes as a principal compo­nent surrounded by thin connective tissue capsule. At time it may simulate the histologic appearance of angiolipoma or foreign-body type of granuloma. [5]

  Case Report Top

A 60-year-old woman presented with bilat­eral, symmetrical, multiple, subcutaneous painful lumps over extremities for the last 3 years. She also gave history of loss of weight for the last one year and was menopausal for last 13 years. The patient was a known case of rheumatoid arthritis for the last four years for which she was taking analgesics but the painful lumps did not respond. On examination, the plaques were varying in size from 2cm-10cm, with ill to well-defined margins, soft, tender and freely mobile. The patient was depressed because of her ailment. Routine investigations were normal. Histo­pathology of the lesion showed mature adipocytes compressing the fibro-vascular septa present be­tween the lobules and connective tissue capsules surrounding the lesion. [Figure - 1]

  Discussion Top

Here we report a rare case of adiposis dolorosa. Adiposis dolorosa is a clinical syndrome characterised by classical triad of painful plaques, ecchymoses and obesity/asthenia in a menopausal female with psy­chic disturbances. [1] Our case fulfilled the clinical cri­teria i.e. she was a menopausal, asthenic, depressed female with painful plaques over extremities. Histopathology confirmed the diagnosis.

  References Top

1.Black MM, Cunliffe WJ. Dercum's disease. In: Champion RH, Bur­ton JL, Burns DA, Breathnach SM eds. Textbook of Dermatology. Blackwell Scientific Publications,Oxford, 1998: 2434-2435.  Back to cited text no. 1    
2.Lynch HT, Harlan WL. Hereditary factors in adiposis dolorosa (Dercum's disease). Am 3 Hum Genet 1963; 15 : 184-190.  Back to cited text no. 2    
3.Palmar ED. Dercum's disease: adiposis dolorosa. Am Fam Physi­cian 1981; 24 : 155-157.  Back to cited text no. 3    
4.Petersen P, Kastrup J. Treating the pain of Dercum's disease. Br Med 3 1984; 288: 1880.  Back to cited text no. 4    
5.Ragsdale BD. Lipomas. In: Elder D, Elenitsas R, Jaworsky C. Johnson Jr B eds. Lever's Histopathology of the Skin. Lippincott - Raven Publishers, Philadelphia, 1997; 937-942.  Back to cited text no. 5    


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