Histology

Adiposis dolorosa (Dercum’s disease)

Adiposis dolorosa (Dercum's disease), coined by Dercum in 1892, is a rare disease of subcutaneous fat characterized by localized overgrowth of fat with painful subcuta­neous plaques. 

It is commonly seen in menopausal obese females and is often associ­ated with fatigue, weakness and severe emotional disturbances. 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. The most common locations for painful fat and for lipomas are the extremities, the trunk, the pelvic area, and the buttocks. Dercum’s disease most commonly appears between the ages of 35 and 50 years. It is five to thirty times more common in women than in men and, originally, Dercum proposed that the condition mainly affects postmenopausal women. Furthermore, Dercum attributed the disease to an endocrine dysfunction such as thyroid gland or hypophyseal dysfunction. The disease does not respond to routine analgesics but only to IV lidocaine.