View 7 excerpts, cites background and methods. Apply this mixture with sufficient water over the lipoma. Primary cutaneous B-cell lymphoblastic lymphoma in children. Matarasso A, Pfeifer TM. Adiposis dolorosa or Dercum's disease consists of a painful progressive localized state of obesity with four cardinal symptoms: a) painful circumscribed or diffuse fatty deposits, b) generalized, View 3 excerpts, references background and methods. Make a stab incision, which can be as small as one-fourth of the lipoma's diameter. Get a FREE Second Opinion from Top Surgeons! J. K. Yee, S. A. Phillips, K. Allamehzadeh, and K. L. Herbst, Subcutaneous adipose tissue fatty acid desaturation in adults with and without rare adipose disorders, Lipids in Health and Disease, vol. However, you must consult an ayurvedic practitioner for these treatments. Imaging may aid in diagnosis. Efficacy will be determined by ultrasound assessment of the lipoma/nodule dimensions after treatment vs baseline. Many people with lipoma dont notice its presence, as it is painless. 2011 Sep 28. Marjon Vatanchi, MD Board Certified Dermatologist, Board Certified Micrographic Dermatologic Surgeon [QxMD MEDLINE Link]. Information about the frequency and severity of symptoms should also be recorded by a medical professional. Does it work?. Most lipomas dont need any treatment, but if it is bothering you, the only way to get rid of it is to remove it surgically. It has been reported as tried by 6% of the members. Attorneys understand the requirements that the SSA maintains and ensure that these requirements are met to increase the chances that their clients will be approved. Share cases and questions with Physicians on Medscape consult. Common symptoms of Dercum's are weight gain that is unrelated to diet or exercise, strange accumulations of fat that have an abnormal consistency, feelings of extreme tiredness and pain to the touch in the affected areas. 1990 Feb. 85(2):289-92. [23, 24] This study suggested that low concentrations of deoxycholate may be a safe and effective treatment for small collections of fat. Dercum's disease (adiposis dolorosa). 1986 Aug. 15(2 Pt 2):383-5. Managing patients with this condition can prove to be difficult as there is no standard of care for symptom control. Ann Plast Surg. D. Masic, E. Liang, C. Long, E. J. Sterk, B. Barbas, and M. A. Rech, Intravenous lidocaine for acute pain: a systematic review, Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, vol. * By clicking on the above button you agree to receive updates on WhatsApp. Massage is a treatment often tried in the Dercum's disease community. During one episode, she went to the emergency room due to severe pain. When left to grow without attention or removal, lipomas can begin to be associated with symptoms such as swelling, tenderness or may even become integrated with underlying blood vessels. Bassetto F, Scarpa C, De Stefano F, Busetto L. Surgical treatment of multiple symmetric lipomatosis with ultrasound-assisted liposuction. Dercums disease can be defined as in combination with chronic painful adipose tissue. Robert A Moraru, MD is a member of the following medical societies: American Academy of DermatologyDisclosure: Nothing to disclose. Dementia can occur at an accelerated rate in people who have Dercums disease. Unlock Your Beauty Potential: Discover the Best Cosmetic Services for Healthy Veins and Glowing Skin. HexaHealth Care Team brings you medical content covering many important conditions, procedures falling under different medical specialities. 2008 Dec. 30(6):590-2. 1997 Dec. 27(6):1141. A group of 10 patients with Dercums disease reported improvement in pain after 5 days of rapidly cycling hypobaric pressure [21]. An interesting case of Dercum's disease is presented in a 53-year-old female who initially presented with a six-week history of painful subcutaneous masses and underwent surgical excision of a select number of these masses, with histopathology consistent with lipomas. [QxMD MEDLINE Link]. Pain associated with Dercums disease can often be severe. Pain may be caused by lipomas pressing on nearby nerves or inflamed connective tissue, also called fascia, which is commonly associated with the lipomas. Dercums disease mainly occurs in adults and more women are affected than men. Treatment for adiposis dolorosa is handled by treating the symptoms, not the actual disorder. 7, no. Interferon alfa-2b induced long-term relief of pain in two patients with adiposis dolorosa and chronic hepatitis C. J Hepatol. 5, p. 717, 2007. Such differential diagnoses to consider are fibromyalgia, lipoedema, panniculitis, endocrine disorders, primary psychiatric disorders, multiple symmetric lipomatosis, familial multiple lipomatosis, and adipose tissue tumours. American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery. [QxMD MEDLINE Link]. It helps to The clinical significance of these findings is unclear [8]. BMC Res Notes. 1996 Mar. 51, no. Clinical orthopaedics and related research, By clicking accept or continuing to use the site, you agree to the terms outlined in our. Developed & Marketed by. 8, no. If you have symptoms, you should see your doctor or a pain specialist to help control your pain. WebCommon treatments for Dercum's disease is directed towards treating the individual symptoms. [QxMD MEDLINE Link]. Janet Fairley, MD Professor and Head, Department of Dermatology, University of Iowa, Roy J and Lucille A Carver College of Medicine To discuss SSD and SSI claims or appeals, please call us at (215) 464-7200 or email the attorneys of Chermol & Fishman, LLC. This may include, but is not limited to, analgesics, surgical excision of troublesome lesions, and psychotherapy 2. Green gram is a potent eliminator of Kapha-Pitta. Besides taking medication to relieve bodily pain, someone with Dercum's disease can have especially painful lipomas removed surgically or with liposuction. WebDercum's disease, or adiposa dolorosa, is a rare condition characterized by the development of multiple painful subcutaneous lipomas. Recurrent seizures and a progressive decline in mental function may occur. When asymptomatic, lipomas can be left alone. The team at the St. Louis Laser Lipo and Vein Center are here to walk patients through their financing and payment plan options in-clinic. Another example is that the samaka lepa and sotha nashaka lepa may aggravate the vata and cause skin dryness. He was the first to notice and ultimately categorize the symptoms in patients into a diagnosis. S. Martinenghi, A. Caretto, C. Losio, M. Scavini, and E. Bosi, Successful treatment of dercums disease by transcutaneous electrical stimulation: a case report, Medicine (Baltimore), vol. 115(5):1425. WebWhats the Treatment? To that end, there are a number of steps that patients can take to alleviate the symptoms associated with Dercums Disease as well as cosmetic interventions that can help with physical appearance of lumps and associated confidence issues. We present a case of a 48-year-old female who presented to the clinic for established care. 2014 Nov. 73(5):559-62. Please confirm that you would like to log out of Medscape. J Am Acad Dermatol. Liposuction for lipomas. This involves several approaches, such as manual decongestive therapy, wrapping, compression garments and pumps, and exercise. Factors in the differential diagnosis of lipoma and sarcoma. Brodovsky S, Westreich M, Leibowitz A, Schwartz Y. Adiposis dolorosa (Dercum's disease): 10-year follow-up. Just as symptoms vary, so do the types of adiposis dolorosa. If the applicant cannot perform job tasks with accommodation, the SSA will investigate the work history of the individual to determine whether the applicant could work in any other position for which they are qualified. 6, pp. 7 (6):46-8. Dercums Disease also known as Adiposis Dolorosa was first discovered by prominent American Neurologist, Francis Xavier Dercum, in 1888. 8(1):24. Amber KT, Ovadia S, Camacho I. Injection therapy for the management of superficial subcutaneous lipomas. All You Need To Know About Chronic Venous Insufficiency, Dont Let Chest Veins Affect Your Confidence: Explore Effective Treatment Solutions in St. Louis, The Silent Killer: How Stress Affects Your Vein Health, Say Goodbye to Vein Problems: Discover the Top Factors That Make You a Great Candidate for Treatment, Understanding Lymphedema for World Lymphedema Day. 2009 Jul. 76(2):170-1. When asymptomatic, lipomas can be left alone. 2011 Jul-Aug. 15(4):230-5. WebDercum's Disease is a condition characterized by a deposit of symmetric nodular or pendulous masses of fat in various regions of the body, with discomfort or pain. There are no specific tests for diagnosing Dercum's disease. Upon chart review, the patient had a medical history of type 2 diabetes, Hashimotos disease, migraines, and obesity. 2018 Jun 28. The associated symptoms in Dercums disease include fatty deposits, easy bruisability, sleep disturbances, impaired memory, depression, difficulty concentrating, anxiety, rapid heartbeat, shortness of breath, diabetes, bloating, constipation, fatigue, weakness and joint aches.ClassificationWe suggest that Dercums disease is. The approach to management of Dercums disease involves pain control through oral medications or direct injections or surgical removal. The procedure was performed under ultrasound guidance. 243(3):197-201. 1985 Nov. 11(11):1070-4. Chondroid lipoma of the neck: a case report. A common chemical used is lecithin (phosphatidylcholine isoproterenol), a lipolytic agent. Currently, there is no standard of therapy but several options described in numerous case reports exist for reducing symptoms. The Social Security Administration (SSA) will evaluate proof of Dercums Disease Disability to determine whether symptoms and complications are severe enough to make it impossible for the applicant to work. 11 (1):415. All of these solutions in combination can significantly help patients deal with the signs and symptoms of this rare disease which have been reported to include sleep disturbances, mobility issues, fatigue, cardiovascular functions, and gastrointestinal conditions. Lipomas Dimensions will be measured for active vs. placebo at days 28,56,84 Mark the palpable borders on the skin before injecting with local anesthesia, as shown in the image below. U. Wollina, A. Goldman, and B. Heinig, Microcannular tumescent liposuction in advanced lipedema and dercums disease, Giornale italiano di dermatologia e venereologia: organo ufficiale, Societa italiana di dermatologia e sifilografia, vol. They feel rubbery but firm and move when touched. The case of a 58-year-old postmenopausal woman affected by Dercum's disease in the breast is reported, with multiple oval, well-defined, hyperechoic lesions suggestive of breast lipomas. 1983 Dec. 54 (6):929-34. The application of heat makes the treatment more effective. Janet Fairley, MD is a member of the following medical societies: American Academy of Dermatology, American Federation for Medical Research, Society for Investigative DermatologyDisclosure: Nothing to disclose. [QxMD MEDLINE Link]. All Rights Reserved. DeFranzo AJ, Hall JH Jr, Herring SM. Dercums disease (adiposis dolorosa) is a rare disease of unknown etiology characterized by painful subcutaneous adipose tissue deposits with various localization over the body, associated with overweight or obesity and a variety of psychiatric disturbances. [QxMD MEDLINE Link]. Patients with this condition are difficult to diagnose due to its rarity and differing presentations. While ayurveda and home remedies might be helpful in certain conditions, lets explore their utility in the case of lipomas. Similarly, those patients that elect to combine lipoma removal with liposuction will find that tumescent approaches come with minimal recovery periods and dont require the use of stitches, greatly reducing the risk of scarring. It is demonstrated that liposuction cannot yet be recommended as the standard treatment for Dercums disease and that neuropeptide levels seem to be normal and that the aetiology of the disease might not be inflammatory. One study found that adipose IL-6 and IL-13 levels were significantly elevated in women with Dercums disease compared to matched controls, while Fractalkine and MIP-1b levels were significantly lower. [QxMD MEDLINE Link]. 3-4, pp. A lipoma is an oval or round fatty tissue lump that grows just beneath the skin that are harmless and are noncancerous. Inflammation has also been suggested but not been shown to vary significantly on histopathology between fat biopsies of painful and nonpainful areas in patients with Dercums disease, or compared with obese control patients [10]. Epidemiology for the condition is not defined, but the literature suggests a higher prevalence in obese females, aged 3550 [1].The disease is often accompanied by a number of associated symptoms such as weakness, fatigue, depression, and dementia [2]. Dr. 6, pp. Eventually, the patient was lost to follow-up, and means of communication went unanswered. The prognosis of Dercums disease is that its a chronic condition that develops gradually. While this diagnosis seems to be more common for women than men, it is not categorized as a gender-specific disease. View chapter Purchase book Tumors of fat, muscle, cartilage, and bone Tammie Ferringer, in Dermatopathology (Second Edition), 2014 Lipoma Key features Well-circumscribed tumor with a thin capsule Mature lipocytes J Dermatol Surg Oncol. In addition, case reports exist supporting the potential use of pregabalin [16], D-amphetamine [16], metformin [17], interferon alfa-2b [18], infliximab, and methotrexate [19] in managing pain. Dercums disease is a rare condition that is characterized by painful lipomas and other nonspecific symptoms. The paperwork that is required in order for an application to be considered contains multiple parts. You will know whether the ayurvedic treatment for lipoma is working or not by observing changes in the size of the lipoma. Apply ghee over it to prevent aggravation of Vata due to skin dryness. Wolfe SW, Bansal M, Healey JH, Ghelman B. Computed tomographic evaluation of fatty neoplasms of the extremities. 46, no. WebMateria Medica : Herbal Treatment for Dercum's Disease Single Herb Castor Oil ( Arandi ) for Dercum Apply Castor Oil directly to the painful or Inflamed area of the body. Orthopedics. 2009 Jul. Even healthcare providers are still determining what causes lipoma. A clinical, radiographic, and histologic review of cases. 2015 Jan-Feb. 32 (1):e36-8. While surgical options such as liposuction have been known to be helpful, it doesnt guarantee that lipomas wont return. However, frequent surgeries can risk health complications, and less extreme methods of treatment are encouraged. He was the first to notice and ultimately categorize the symptoms in patients into a diagnosis. Instead, treatment usually focuses on pain management using: In many cases, people with Dercums disease benefit the most from a combination of these treatments. Consider working with a pain management specialist to find the safest combination thats most effective for you. Dercums disease can be hard to diagnose and treat. There is an increasing awareness that cannabis has the ability to help manage pain, inflammation, or neurogenerative diseases such as Alzheimers and Parkinsons.But the true potential of using medicinal cannabis for rare diseases and disorders has yet to be unlocked. Copyright 2020 Cameron Moattari et al. In this blog, we will explore the best Ayurvedic medicines for lipoma. The vast majority of patients that are diagnosed with Dercums Disease will see the condition progress over time. S. S. Greenbaum and J. Varga, Corticosteroid-induced juxta-articular adiposis dolorosa, ArchDermatol, vol. 10311038, 2009. Plast Reconstr Surg. K. Herbst and T. Rutledge, Pilot study: rapidly cycling hypobaric pressure improves pain after 5 days in adiposis dolorosa, Journal of Pain Research, vol. Instead, treatment usually focuses on pain management using: prescription pain relievers cortisone injections calcium channel modulators methotrexate infliximab 127, no. Treatment is directed toward the specific symptoms that are apparent in each individual and is primarily focus 1, pp. By 1997, it had become clear that lipedema is a chronic disease with symmetrical impairment of the fatty tissue distribution. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); 11450 Bustleton AvenuePhiladelphia, PA 19116, 220 Lake Drive East, Suite 205 Cherry Hill, NJ 08002, 4105 Spring Meadow LaneFlower Mound, TX 75028, 16445 Collins Avenue Sunny Isles, Fla Unit #: 1022, FL 33160, 2116 Cumberland Ave Middlesboro, KY 40965, Copyrights 2023 Chermol & Fishman, LLC. Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Pennsylvania Academy of DermatologyDisclosure: Received royalty from Lippincott Williams Wilkins for textbook editor. The advantages of liposuction include reduced operative time and smaller incisions. K. abuzek, S. Liber, D. Suchy, and B. Okopie, A successful case of pain management using metformin in a patient with adiposis dolorosa, International Journal of Clinical Pharmacology and Therapeutics, vol. Therefore, to maintain balance in the tridoshas, a person can make the following lifestyle changes: Lipoma, a soft lump of fatty tissue, is typically painless and requires medical attention only when you causes discomfort and want it surgically removed. [20]. 9, pp. R. Crescenzi, P. M. C. Donahue, S. Weakley, M. Garza, M. J. Donahue, and K. L. Herbst, Lipedema and dercums disease: a new application of bioimpedance, Lymphatic Research and Biology, vol. For pitta dosha, do yoga asanas including Bakasana, Malasana, Vajrasana, Tadasana, Trikonasana, etc. 3, pp. [18] Topical EMLA (eutectic mixture of lidocaine and prilocaine in a ratio of 1:1 by weight) also has been used for Dercum disease. While this condition can present itself at any time, adults between the ages of 35 and 50 are more likely to develop the disease than any other age group. 44 (7):e156-e157. Robert A Moraru, MD Staff Physician, Department of Dermatology, St Luke's/Roosevelt Hospital Center, Columbia Presbyterian Medical Center WebWhat is the treatment for Dercum disease? Eat foods that bring balance to tridoshas. They are not associated with any discharge or symptoms on the skin except the presence of a harmless-looking swelling. Several novel and noninvasive procedures have also been described as beneficial. There is no cure for Dercum's disease, and treatment involves management of symptoms 3. This is why it is important for sufferers to seek medical attention. 17, no. She continues her passion for helping people with connective tissue disorders as part of Total Lipedema Care. As you know Dercum's disease, familial multiple lipomatosis (FML), adiposis dolorosa or lipomas are rare conditions. E. Hansson, J. Manjer, H. Svensson, and H. Brorson, Quality-of-life in patients with dercums disease-before and after liposuction, Journal of Plastic Surgery and Hand Surgery, vol. [QxMD MEDLINE Link]. 1994 Dec. 33(6):664-8. [QxMD MEDLINE Link]. 27, no. Here are some possible side effects of ayurvedic medicines for lipoma: It is important to work with a qualified ayurvedic practitioner who can provide individualised guidance and monitor your progress to minimise the risk of side effects. [QxMD MEDLINE Link]. Some patients may find that liposuction proves to be an efficient route to helping to slow Dercums Disease or reduce the appearance of lumps. Men and women are equally prone to developing lipomas across the body at any given time during their lives. Depression, difficulty concentrating, and irritability are also common symptoms associated with this condition. A 43-year-old man with a slow-growing asymptomatic growth. WebMassage in Dercum's Disease. Surgical excision of a 6-cm lipoma on the back of a 54-year-old man using the squeeze technique. [ 1] A multidisciplinary approach to treatment is recommended. 4, Article ID 7129748, pp. Many people seek alternative treatments such as Ayurveda, to manage lipoma without surgery. The pain rate was 710/10 during her episodes and could last minutes to days, with the longest episode of generalized pain lasting for 32 days. Dercums Disease was identified by Dr. Franxiz Xavier Dercum in 1888 during his time with the University of Pennsylvania. For vata balancing, practice Anulom Vilom, Bharamri, Agnisar, Nadishodhana, etc. Therapeutic options that have been suggested by case reports include analgesics, liposuction, lipectomy, manual lymphatic drainage, and minimal incision Express the lipoma by putting pressure on the lateral aspects of the incision, as shown in the image below. Surgical excision, in this case, relieved the patient's symptoms locally, but after one year the painful lipomata had appeared at other sites, and there is no effective treatment for this condition. She was referred to physical therapy and was managed in an outpatient setting for years for her pain control which included oxycodone 10mg BID, ibuprofen 800mg TID, and alprazolam 0.5mg TID PRN for anxiety. Practice breathing exercises (pranayama) to balance your doshas. [QxMD MEDLINE Link]. Treatment for Dercums disease revolves around managing pain. 2020 Jan. 49 (1):129-135. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. Prescription of anti-inflammatory and analgesics was progressively decreased: prednisone was rapidly tapered and stopped within 2 weeks from the start of Dercums disease (adiposis dolorosa) is a rare disease of unknown etiology characterized by painful subcutaneous adipose tissue deposits with various localization over the body, associated with overweight or obesity and a variety of psychiatric disturbances. Theres no reason to wait when youre considering your options for treating Dercums Disease or the removal of lipomas. B. Riaz, B. Kalb, and K. L. Herbst, Low-dose d-amphetamine induced regression of liver fat deposits in dercum disease, The American Journal of Medicine, vol. Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. Lipomas that initially appear slowly will generally continue to develop more rapidly with time. Increased physical activity aids both in edema reductionthrough the pumping action of the calf musclesand weight loss. 1, p. 23, 2012. In Dercum disease, medical treatment can be offered using steroids and analgesic medications. 10471053, 2013. A skilled Disability Lawyers in Texas can provide the guidance needed to get disabled individuals through the application process. Thank you for pointing out that this discussion Lipoma treatment in ayurveda aims to balance the body's doshas (vata, pitta, and kapha) and improve the digestive system, as imbalances in these areas are thought to contribute to the development of lipomas. Expression of HMGI-C and HMGI(Y) in ordinary lipoma and atypical lipomatous tumors: immunohistochemical reactivity correlates with karyotypic alterations. Next, massage some lukewarm sesame oil (Tila Taila) over the lipoma. A few lipoma treatments in Ayurveda, such as black sesame lepa, samaka lepa, sotha nashaka lepa, and triphala kala basti, might help you reduce the size of the lipoma. The minimum definition of Dercums disease proposed by Hansson et al. Mesotherapy: what is it? Remove the Lepa as soon as you feel skin tightness or itchiness over the affected area. Randomized, controlled trials are needed to confirm the data described in these studies. Ranked #5 most tried. 6, pp. The initial consultation is free, and we never charge a fee until we win your case. The patient reported severe constant diffuse pain, poor appetite, and difficulty sleeping because of the pain. 252256, 2012. Book an Appointment , Side Effects of Ayurvedic Medicines for Lipoma, Dos and Donts for Lipoma Treatment in Ayurveda. Cover the lipoma with two layers of cotton cloth. S. Ghazala, J. Bilal, E. Ross, I. Based on 45 member reports. A licensed medical provider can put together the required records that outline the results of diagnostic tests. There are no clear laboratory markers for the condition. It should not be used for medical advice, diagnosis or treatment. Sawamura S, Kajihara I, Jinnin M, Honda Y, Ihn H. Cutaneous spindle cell adenolipoma on the nose: A rare variant of lipoma. Most patients with generalized diffused form and juxta-articular form of Dercums disease experience some pain relief after liposuction, but it is impossible to determine who will have a substantial effect of the treatment. Int J Clin Pharmacol Ther. 26:146-9. WebAdiposis dolorosa, also known as Dercums disease, is a rare disease that causes painful growths of fatty tissue called lipomas. The patients clinical picture was in favor of the diagnosis of Dercums disease. [Full Text]. In 2018, a Polish study showed that Aqualyx (12alfa-dihydroxy-5beta-24-oico cholanic acid sodium salt) dissolved 70% of treated lipomas. However, one study showed that when lecithin solubilized with deoxycholate and was used to treat subcutaneous lipomas, the active ingredient was actually the deoxycholate rather than the phosphatidalcholine. It's also important to consult with a qualified ayurvedic practitioner to ensure that any treatments are appropriate for your individual needs and health status. Hereditary multiple lipomatosis: Natural remedies: Ayurveda offers natural remedies that use herbs, oils, and other natural ingredients to help reduce the size of lipomas over time. Applicants often feel overwhelmed and alone when they are trying to get the benefits that they need to pay for housing and other basic necessities. Am J Pathol. MRI may demonstrate multiple small, oblong, fatty lesions in the subcutaneous tissue with a nodular increased fluid signal that appears blush-like. Ultrasound may show hyperechoic nodules [4]. 31(5):423-6. [QxMD MEDLINE Link]. [QxMD MEDLINE Link]. People who suffer from Dercums Disease may wonder if they can qualify for SSD benefits. Arch Dermatol. 517524, 2013. Vineet Mishra, MD, FAAD Director of Mohs Surgery and Dermatologic Surgery, Assistant Professor of Dermatology, University of Texas Health Science Center at San Antonio Unfortunately Dercums Disease is considered one of the rarest diseases on earth. It is sadly both rare and relatively unknown. This makes it very difficult to find readily available experts. To our knowledge, there are only two doctors who have published true multi-year double-blind clinical studies of the disease in the past twenty years. [QxMD MEDLINE Link]. 2017 Jul. You will inevitably visit many specialists, but it WebDercums Disease was identified by Dr. Franxiz Xavier Dercum in 1888 during his time with the University of Pennsylvania. Mullane AM, Ricci A, Misra S, Aydin N. Dermatofibrosarcoma protuberans post basal cell carcinoma excision: A case report. 6, pp. This normally includes creams that are lidocaine- or capsaicin -based. Advancements in the world of medical and surgical treatments mean that patients looking to have lipomas removed, or those that require multiple removals with a diagnosis of Dercums Disease, can do so without undergoing large open surgical procedures. These lipomas, or adipose tissues, can sit on nerves and cause a lot of pain or even impair movement. J Cosmet Dermatol. The significantly lower prevalence of DM2 in people with lipedema compared with DD may be due to the greater amount of gynoid fat known to be protective against metabolic disorders. After obtaining hemostasis, close the dead space using buried absorbable sutures. Effective treatment for patients with Dercums disease is currently lacking as there is no effective long term treatment.