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.
Erectile dysfunctions are a common feature in patients with systemic sclerosis. They are resulted from a complex pathomechanism. The main role is attributed to vascular alterations and fibrosis of the carvernous bodies. Depression and disturbed autonomy nervous system function may be additional factors for development of erectile dysfunctions. Diagnosis is based on subjective patient's data and functional tests. Treatment of erectile dysfunctions in scleroderma patients is difficult, multifactorial and sometimes ineffective.
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