Improvement of juxtaarticular adiposis dolorosa by fat suction

Scheinberg, Morton; Diniz, Ricardo E.A.S.; Diamant, Jorge

doi:10.1002/art.1780301220

Cited by 8 publications

(4 citation statements)

References 9 publications

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“…Case reports [23][24][25] have suggested that liposuction may have the potential to ameliorate that pain. Nociception is conducted by two types of nerve fibres: the myelinated Adelta fibres, that also conduct the cold sense; and more slowly conduction C fibres, that also conduct the warm sense.…”

Section: Discussionmentioning

confidence: 99%

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

Hansson

Svensson

Rosén

et al. 2011

Journal of Plastic Surgery and Hand Surgery

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Section: Discussionmentioning

confidence: 99%

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

Hansson

Svensson

Rosén

et al. 2011

Journal of Plastic Surgery and Hand Surgery

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“…The pain in Dercum’s disease is often refractory to analgesics and to non-steroidal anti-inflammatory drugs (NSAIDs) [44,56,67,68,92-98]. However, this has recently been contradicted by the findings of [Herbst et al 7].…”

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

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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“…Other proposed treatments, for instance lignocain infusions, often have insufficient or merely temporary effect [2,3]. However, five case reports [4–8] have been published on the encouraging effect of liposuction, showing that nine patients experienced a considerable subjective pain relief postoperatively with a follow‐up between 1 and 2 years. None of the reported patients experienced any recurrence of pain within this time.…”

Section: Introductionmentioning

confidence: 99%