Corticosteroids

A few patients noted some improvement when treated with systemic corticosteroids (prednisolone) [1-3], whereas others experienced worsening of the pain [4]. Weinberg et al. [5] 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 [6]. 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.

1. Palmer ED: Dercum’s disease: adiposis dolorosa. Am Fam Physician 1981, 24:155–157.
2. Brodovsky S, Westreich M, Leibowitz A, Schwartz Y: Adiposis dolorosa (Dercum’s disease): 10-year follow-up. Ann Plast Surg 1994, 33:664–668.
3. Spota BB, Brage D: Cortisone therapy of Dercum’s disease. Dia Med 1952, 24:1930–1932.
4. Greenbaum SS, Varga J: Corticosteroid-induced juxta-articular adiposis dolorosa.Arch Dermatol 1991, 127:231–233.
5. Weinberger A, Wysenbeec AJ, Pinkhas J: Juxta-articular adiposis dolorosa associated with rheumatoid arthritis. Report of 2 cases with good response to local corticosteroid injection. Clin Rheumatol 1987, 6:446–448.
6.  Cross SA: Pathophysiology of Pain. Mayo Clin Proc 1994, 69:375–383.

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