Description, Causes and Risk Factors:
Adiposis dolorosa is a condition characterized by painful folds of fatty (adipose) tissue or the growth of multiple benign (non-cancerous) fatty tumors called lipomas. This condition occurs most often in women who are overweight or obese, and signs and symptoms typically appear between ages 35 and 50.
In people with adiposis dolorosa, abnormal fatty tissue or lipomas can occur anywhere on the body but are most often found on the torso, buttocks, and upper parts of the arms and legs. Lipomas usually feel like firm bumps (nodules) under the skin. The growths cause burning or aching that can be severe. In some people, the pain comes and goes, while in others it is continuous. Movement or pressure on adipose tissue or lipomas can make the pain worse.
The cause of adiposis dolorosa is unknown. The condition is thought to have a genetic component because a few families with multiple affected family members have been reported. However, no associated genes have been identified.
Several other possible causes of adiposis dolorosa have been suggested, although none have been confirmed. They include the use of medications called corticosteroids, dysfunction of the endocrine system (which produces hormones), or changes in the deposition and breakdown of fat (adipose tissue metabolism).
Researchers have also suggested that adiposis dolorosa could be an autoimmune disorder, which occurs when the immune system malfunctions and attacks the body's own tissues and organs. However, there is no firm evidence that the condition is related to abnormal inflammation or other immune system malfunction.
It is unknown why adiposis dolorosa usually occurs in people who are overweight or obese, or why the signs and symptoms do not appear until mid-adulthood.
Shortness of breath.
Muscle and joint aches.
Fatigue and weakness.
Other signs and symptoms that have been reported to occur with adiposis dolorosa include, depression, irritability, confusion, recurrent seizures (epilepsy), and a progressive decline in intellectual function (dementia). These problems do not occur in everyone with adiposis dolorosa, and it is unclear whether they are directly related to the condition.
Diagnosis is mainly clinical (the association of pain and the fatty acid deposits with obesity is a key factor for diagnosis) and is often delayed due to the diverse spectrum of manifestations. Ultrasound and MRI are useful diagnostic tools for identifying the masses as lipomas. The differential diagnosis should include fibromyalgia, other multiple lipoma syndromes such as familial symmetric lipomatosis, Proteus syndrome, MERRF syndrome with lipomatous lesions, neurofibromatosis type 1 (NF1) and multiple endocrine neoplasia type 1.
Two treatment options are described in the literature: Surgical and medical. Surgical treatment is based on lipoma excision or on liposuction. The pain ceases almost immediately, but there are frequent relapses that may be identified by imaging. Medical therapy consists of repeated intravenous administration of lidocaine, with complete pain relief occurring within 10 hours to 12 months after treatment. Local corticosteroid (prednisone) injections and combinations of mexiletine and amitriptyline, or infliximab and methotrexate are also reported.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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