How do you manage patients with Dercum's disease?

Fortunately, I haven't had too many patients with Dercum's Disease (Adiposis Dolorosa). I had a patient with a few tumors that were particularly painful. We excised those tumors, which helped her. I've never tried an intralesional steroid injection, but I know it's been reported. In terms of systemic pain control, I don't see evidence for cannabinoids, but I think they hold a lot of potential in this area.

This is a rare disorder. There is no standard treatment. Usually, therapy is catered to specific symptoms. Pain can affect QOL. Pain management strategies can be used with the assistance of our pain management colleagues. Lipectomy can be used and can be effective five for pain control but the pain tends to reoccur. There have been other modalities reported with mixed results such as methotrexate.