A few patients noted some improvement when treated with systemic corticosteroids (prednisolone) [1-3], whereas others experienced worsening of the pain . Weinberg et al.  treated two patients with juxta-articular Dercum’s disease with intralesional injections of methylprednisolone (Depo-Medrol®). The patients experienced a dramatic improvement.
The mechanism for the pain-reducing ability of corticosteroids in some conditions is unknown. One theory is that they inhibit the effects of substances, such as histamine, serotonin, bradykinin, and prostaglandins . As the aetiology of Dercum’s disease is probably not inflammatory, it is plausible that the improvement some of the patients experience when using corticosteroids is not caused by an anti-inflammatory effect.
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