Advertisement

Wiener Medizinische Wochenschrift

, Volume 165, Issue 17–18, pp 374–377 | Cite as

Juxta-articular adiposis dolorosa (Dercum’s disease type IV): report of four cases and treatment by dermolipectomy

  • Uwe WollinaEmail author
  • Birgit Heinig
  • Dana Langner
  • Andreas Nowak
brief report

Summary

Juxta-articular adiposis dolorosa is a rare subtype of Dercum’s disease. It manifests mainly on the medial parts of the knees. Pain and impaired mobility are common symptoms. We report on four females (aged between 52 and 83 years) who suffered from juxta-articular adiposis dolorosa for more than 10 years. These patients were successfully treated by dermolipectomy resulting in dramatically improved pain and mobility. Adverse effects and complications were minor with a lymph fistula in a single patient which was treated by surgery.

Keywords

Juxta-articular adiposis dolorosa Dercum’s disease Dermolipectomy Comorbidities 

Juxtaartikuläre Adiposis dolorosa (Mb. Dercum Typ IV) – Bericht über 4 Patienten und ihre Behandlung mittels Dermolipektomie

Zusammenfassung

Die juxtaartikuläre Adiposis dolorosa ist ein seltener Subtyp des Mb. Dercum. Er manifestiert sich hauptsächlich am medialen Knie. Schmerzen und Bewegungsbehinderungen sind häufige Symptome. Wir berichten über 4 Frauen (Alter zwischen 52 und 83 Jahren), die an einer juxtaartikulären Adiposis dolora über mehr als 10 Jahren litten. Die Patienten wurden erfolgreich mittels Dermolipektomie behandelt, was sich in einer dramatischen Verbesserung von Schmerzen und Mobilität zeigte. Komplikationen waren geringgradig. Bei einer Patientin kam es temporär zu einer Lymphfistel, die chirurgisch behandelt wurde.

Schlüsselwörter

Juxtaartikuläre Adiposis dolorosa Mb. Dercum Dermolipektomie Komorbiditäten 

Notes

Conflict of Interest

U. Wollina, B. Heinig, D. Langner, and A. Nowak delcare that there are no actual or potential conflicts of interest in relation to this article.

References

  1. 1.
    Hansson E, Svensson H, Brorson H. Review of Dercum’s disease and proposal of diagnostic criteria, diagnostic methods, classification and management. Orphanet J Rare Dis. 2012;7:23.PubMedCentralCrossRefPubMedGoogle Scholar
  2. 2.
    Stutz J. Liposuktion beim Lipödem zur Verhinderung von Gelenkspätkomplikationen. Vasomed. 2011;23:2–6.Google Scholar
  3. 3.
    Ruhdorfer A, Wirth W, Dannhauer T, Eckstein F. Longitudinal (4 year) change of thigh muscle and adipose tissue distribution in chronically painful vs painless knees—data from the Osteoarthritis Initiative. Osteoarthr Cartil. 2015. doi: 10.1016/j.joca.2015.04.004. [Epub ahead of print].
  4. 4.
    Richter M, Trzeciak T, Owecki M, Pucher A, Kaczmarczyk J. The role of adipocytokines in the pathogenesis of knee joint osteoarthritis. Int Orthop. 2015;39(6):1211–7.CrossRefPubMedGoogle Scholar
  5. 5.
    Schmeller W, Meier-Vollrath I. Tumescent liposuction: a new and successful therapy for lipedema. J Cutan Med Surg. 2006;10(1):7–10.CrossRefPubMedGoogle Scholar
  6. 6.
    Wollina U, Goldman A, Heinig B. Microcannular tumescent liposuction in advanced lipedema and Dercum’s disease. G Ital Dermatol Venereol. 2010;145(2):151–9.PubMedGoogle Scholar
  7. 7.
    Daabiss M. American Society of Anaesthesiologists physical status classification. Indian J Anaesth. 2011;55(2):111–5.PubMedCentralCrossRefPubMedGoogle Scholar
  8. 8.
    Wollina U, Heinig B, Schönlebe J, Nowak A. Debulking surgery for elephantiasis nostras with large ectatic podoplanin-negative lymphatic vessels in patients with lipo-lymphedema. Eplasty. 2014;14:e11.PubMedCentralPubMedGoogle Scholar
  9. 9.
    Kim DI, Lee BB, Huh S, Lee SJ, Hwang JH, Kim YI. Excision of subcutaneous tissue and deep muscle fascia for advanced lymphedema. Lymphology. 1998;31(4):190–4.PubMedGoogle Scholar
  10. 10.
  11. 11.
    Hansson E, Svensson H, Stenram U, Brorson H. Histology of adipose tissue inflammation in Dercum’s disease, obesity and normal weight controls: a case control study. J Inflamm (Lond). 2011;8(1):24.CrossRefGoogle Scholar
  12. 12.
    Held JL, Andrew JA, Kohn SR. Surgical amelioration of Dercum’s disease: a report and review. J Dermatol Surg Oncol. 1989;15(12):1294–6.CrossRefPubMedGoogle Scholar
  13. 13.
    Hansson E, Svensson H, Brorson H. Liposuction may reduce pain in Dercum’s disease (adiposis dolorosa). Pain Med. 2011;12(6):942–52.CrossRefPubMedGoogle Scholar
  14. 14.
    Bertheuil N, Huguier V, Beuzeboc M, Aillet S, Watier E. Knee dermolipectomy: a simple operation with significant functional improvement. Aesthetic Plast Surg. 2013;37(1):117–20.CrossRefPubMedGoogle Scholar
  15. 15.
    Rasmussen JC, Herbst KL, Aldrich MB, et al. An abnormal lymphatic phenotype is associated with subcutaneous adipose tissue deposits in Dercum’s disease. Obesity (Silver Spring). 2014;22(10):2186–92.CrossRefGoogle Scholar
  16. 16.
    Schacht V, Ramirez MI, Hong YK, et al. T1alpha/podoplanin deficiency disrupts normal lymphatic vasculature formation and causes lymphedema. EMBO J. 2003;22(14):3546–56.PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Wien 2015

Authors and Affiliations

  • Uwe Wollina
    • 1
    Email author
  • Birgit Heinig
    • 2
  • Dana Langner
    • 1
  • Andreas Nowak
    • 3
  1. 1.Department of Dermatology and AllergologyAcademic Teaching Hospital Dresden-FriedrichstadtDresdenGermany
  2. 2.Center for Rehabilitative Medicine and Physical TherapyAcademic Teaching Hospital Dresden-FriedrichstadtDresdenGermany
  3. 3.Department of Anesthesiology and Intensive Medical Care, Emergency Medicine and Pain ManagementAcademic Teaching Hospital Dresden-FriedrichstadtDresdenGermany

Personalised recommendations