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| | CASE REPORTS | | | | | Year : 2000 | Volume : 66 | Issue : 2 | Page : 101-102 | Adiposis dolorosa
Adarsh Chopra, Puneet Walia, Dimple Chopra, Jassal
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Correspondence Address:
Adarsh Chopra
PMID: 20877043 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 |
| Introduction | |  |
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 | | |
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 | | |
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 | | |
| 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.  | | 2. | Lynch HT, Harlan WL. Hereditary factors in adiposis dolorosa (Dercum's disease). Am 3 Hum Genet 1963; 15 : 184-190. | | 3. | Palmar ED. Dercum's disease: adiposis dolorosa. Am Fam Physician 1981; 24 : 155-157. | | 4. | Petersen P, Kastrup J. Treating the pain of Dercum's disease. Br Med 3 1984; 288: 1880. | | 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. |
Figures [Figure - 1] |
