Diagnosis and Treatment of Dercums disease

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How is the Dercum's disease diagnosed?

The Dercum's disease is usually diagnosed based on the medical history and physical findings of the patient. So, physicians thoroughly discuss about the clinical problems with the affected patients and diagnose the condition through clinical observation. Unlike other diseases, no specific laboratory test can detect the disease however the physician can diagnose it with the aid of magnetic resonance imaging. Blood reports reveal activated immune system and associated infection. The physician can obtain further blood reports to rule out other disorders.

What is the treatment for Dercum's disease?

Currently, the Dercum's disease has no cure and symptomatic treatment is reinforced that can control one symptom rather than the overall disease. The Treatment protocol is specific to each patient and varies from person to person. However, it usually depends on the related symptoms or complications suffered by the patient. The treatment options for controlling the associated symptoms of Dercum's disease include: Medication therapy, surgical therapy, and integrative therapy like weight management plans.

Medication therapy

Medication therapy includes pain relieving medications rather than removal of lipoma. These include narcotic analgesics, NSAIDs, Medical cannabis, Ziconotide, Fentanyl, Lyrica, methotrexate, Butrans, infliximab with or without methotrexate, IV lidocaine infusion and mexiletine, Prednisone, combination of acetaminophen and opioid analgesic, IC cortisone/anesthetic injection, acetaminophen and pregabalin. In addition, long term pain relief is provided by the administration interferon (INF) alfa-2b.

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Patients presenting with fingers swelling require diuretics.

Psychological support is necessary in case of depression and related psychosomatic symptoms.

Patients suffering from osteoarthritis and fibromyalgia should consult a rheumatologist and patients with hypothyroidism and Cushing syndrome should consult an endocrinologist.

Surgical therapy

Isolated, painful lipomas around the joints often require supportive treatment that includes surgical excision procedures like Liposuction. Although, the condition recurs, liposuction can provide temporary relief from localized pain or associated symptoms.

Integrative therapies

These are the options for managing the disease. Appropriate weight loss strategies and supplements are reinforced to overcome obesity and symptoms respectively. However, there is no evidence to prove the efficacy of health supplements and diet therapy. Patients are advised to avoid monotonous work that leads to physical or psychological stress.

References: http://www.genome.gov/17516629

http://en.wikipedia.org/wiki/Adiposis_dolorosa

http://www.webmd.com/a-to-z-guides/dercum-disease

http://www.emergingworlds.com/ch_conditions_detail.cfm?vPageid=157

http://emedicine.medscape.com/article/1082083-treatment#showall

http://emedicine.medscape.com/article/1082083-clinical

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Dr Chaitra S's picture
Author: Dr Chaitra S

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