Classification History: In 1900, Giudiceandrea reviewed all the thus far published cases. Based on the results of the review, he proposed the following clinical classification of Dercum’s disease: I. Nodular type. A form with painful lipomas, most commonly on the arms or the legs or on the back or thorax. Sometimes the lipomas occur on multiple locations and occasionally the lipomas form a confluent mass. The nodules are variable in size and painful on palpation. II. Diffuse type. A form with diffusely painful adipose tissue. The pain is symmetric. III. Mixed type. A form with diffusely painful adipose tissue and with painful nodular masses. In 1901, Roux and Vitaut modified the classification to the following: I. Nodular type. A form with intense pain in and around multiple lipomas. II. Circumscribed diffuse type. A form with painful folds of fats. The folds are often located on the inside of the knee and/or on the hips. III. Generalised diffuse type. A form with diffusely widespread painful adipose tissue. The most common location of the pain is the extremities and the trunk. Another classification: I. Type I - juxta-articular II. Type II - diffuse-generalized III. Type III - nodular is sometimes mentioned. However, we have not been able to establish who made this classification and when it was compiled. The first time the term juxta-articular Dercum’s disease was used was in 1937 by Kling. Based on a review of the literature and studies on 111 patients with Dercum’s disease researchers propose that Dercum’s disease should be classified as: I. Generalized diffuse form: A form with diffusely widespread painful adipose tissue without clear lipomas. II. Generalised nodular form: A form with general pain in adipose tissue and intense pain in and around multiple lipomas. III. Localised nodular form: A form with pain in and around multiple lipomas IV. Juxta-articular form: A form with solitary deposits of excess fat for example at the medial aspect of the knee. The suggested classification would improve the research on Dercum’s disease. biomedcentral/content/pdf/1750-1172-7-23.pdf
Posted on: Tue, 23 Jul 2013 23:07:51 +0000
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