Adiposis dolorosa

Lipomatosis dolorosa is also called obesity dolorosa or morbus dercum. It is a chronic and progressive disease in which there is a painful proliferation of subcutaneous fatty tissue under the skin. The causes of dolorosa lipomatosis are not yet known, but the disease appears to be associated with pathological obesity and disorders of fat and carbohydrate metabolism.

A genetic component cannot be ruled out either, as in a few cases a more frequent occurrence within families can be observed. Lipomas can occur on the whole body except the neck and face. Preferably, however, the fat tumors develop on the abdomen, knees, elbows, thighs and the inner sides of the upper arm.

Affected patients complain of severe pain in the area of the fat deposits and the pain can increase as the disease progresses. The more overweight the patient is, the stronger the pain caused by the lipomas. Typical accompanying symptoms of lipomatosis dolorosa are dry mouth, headaches and swelling.

The doctor diagnoses a case of dolorosa lipomatosis using imaging techniques such as ultrasound and magnetic resonance imaging (MRI). To confirm the diagnosis, small tissue samples (biopsies) are often taken and microscopically analyzed. The pain caused by a lipomatosis dolorosa cannot be treated by traditional pain therapy, but a longer pain-free phase can be achieved by the intravenous administration of lidocaine, an anesthetic.

However, since the administration of lidocaine has strong side effects, a long-term therapy in this form is not possible. Weight reduction does not lead to a regression of lipomas and does not reduce the pain. Finally, there is still the possibility to remove the fat tumors surgically, but often a lipoma develops again at the same place and a relapse occurs.

Lipomas of the breast

Lipomas can occur in one or both breasts in women. If several lipomas form at the same time, this is called lipomatosis. Lipomatosis of the breast is a rare disease, but it is mostly benign. Nodules and swellings form which are located directly under the skin and can therefore be felt from the outside. Under certain circumstances, lipomas in the breast can become very large and cause pain.Normally, however, these lipomas are harmless and do not need to be treated.