Derkuma disease (a synonym for painful lipomatosis, morbid obesity) is lipomatosis, accompanied by a sharp painful fatty deposits in the subcutaneous tissue. Deposits are noted as separate nodes or diffuse formations. More common in women in middle and old age.
Etiology. The development of the disease is facilitated by factors leading to the development of tumors of the hypothalamus, encephalitis and meningoencephalitis, and chronic intoxications.
The pathogenesis of the disease is not clear, however, probably the main point is the defeat of the higher parts of the central nervous system with secondary damage to peripheral nerve formations and a change in the function of endocrine glands.
Clinical picture (symptoms and signs). Distinguish the nodal, diffuse-nodal, diffuse-localized and diffusely-widespread forms of the disease. In the first form, individual nodes of different sizes are located in the usual or excessively developed subcutaneous fat layer. The nodes are well mobile, only in the later stages of the disease are they fused with the underlying aponeurosis. They are located on the entire body, except for the hands, feet and face.The
In diffuse forms of the disease, separate areas of obesity expand on the trunk and thighs, separated from each other by grooves. In the beginning, the skin above them is soft and mobile, then becomes dense and welded to the fatty. Pain can be of a spontaneous nature or can be caused by pressure on adipes, can give to other parts of the body.
The diffuse-nodular form of the disease is a mixed form. Patients complain of dizziness, fainting, headaches, weakness, fatigue, mental disorders in the form of depressions, less often dementias or arousal. There are violations of trophism (baldness, brittle nails, stop sweating), in women - amenorrhea, in men - sexual impotence, often there is a decrease in the function of the thyroid gland.
The course of the disease is long. The prognosis for life is good, with respect to recovery is unfavorable.
It is necessary to distinguish Dercum's disease from neurofibromatosis (Recklinghausen's disease), in which the nodes are more dense, have smaller dimensions, are located along the nerves and often on the hands and feet.
Treatment is ineffective, sometimes, isolated nodes that interfere with the normal function of the limbs or wearing clothing are removed surgically.