Dercum's disease is a rare condition characterized by multiple painful fatty tumors, called lipomas, that can grow anywhere in subcutaneous fat across the body.
Obesity and rapid weight gain is common in DD, with chronic fatigue and pain unresponsive to analgesics.
[6] The disease was described for the first time by an American neurologist Francis Xavier Dercum, who headed the University of Pennsylvania’s Neurological Clinic and was the personal physician to President Woodrow Wilson.
Researchers have proposed a 'minimal definition' based on symptoms most often part of Dercum's disease: 1) Generalized overweight or obesity.
[4] The associated symptoms in Dercum's disease include obesity, fatty deposits, easy bruisability, sleep disturbances, impaired memory, depression, difficulty concentrating, anxiety, rapid heartbeat, shortness of breath, diabetes, bloating, constipation, fatigue, weakness, and joint and muscle aches.
[citation needed] Treatment methods include the following modalities: Surgical excision of fatty tissue deposits around joints (liposuction) has been used in some cases.
Lidocaine An early report from 1934 showed that intralesional injections of procaine (Novocain®) relieved pain in six cases.
In contrast, Atkinson et al. have suggested that an effect on the central nervous system is more likely, as lidocaine can depress consciousness and decrease cerebral metabolism.
In addition, Skagen et al. demonstrated that a patient with Dercum's disease lacked the vasoconstrictor response to arm and leg lowering, which indicated that the sympathicusmediated local veno-arteriolar reflex was absent.
An infusion of lidocaine increased blood flow in subcutaneous tissue and normalised the vasoconstrictor response when the limbs were lowered.
Previously, methotrexate has been shown to reduce neuropathic pain caused by peripheral nerve injury in a study on rats.
The mechanism in the rat study case was thought to be a decrease in microglial activation subsequent to nerve injury.
Furthermore, a study has shown that infliximab reduces neuropathic pain in patients with central nervous system sarcoidosis.
Weinberg et al. treated two patients with juxta-articular Dercum's disease with intralesional injections of methylprednisolone (Depo-Medrol).
As the aetiology of Dercum's disease is probably not inflammatory, it is plausible that the improvement some of the patients experience when using corticosteroids is not caused by an anti-inflammatory effect.
As a pilot study, 10 participants with AD completed pain and quality of life questionnaires before and after 20–40 minutes of CVAC process daily for 5 days.
This study suggests a potential treatment role for CVAC, and the authors recommended randomized controlled clinical trials.
However, a 2007 survey has revealed that 85.7 percent of the included patients developed Dercum's disease before menopause.