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Corticosteroid-Induced Juxta-articular Adiposis Dolorosa

Corticosteroid-Induced Juxta-articular Adiposis Dolorosa Abstract • Long-term treatment with high doses of corticosteroids leads to the development of truncal obesity and focal fatty deposition. These deposits characteristically are located on the face, the nuchal and truncal areas, and episternally, as well as in the mediastinum and epicardium. We studied a patient with juxta-articular adiposis dolorosa who had L-tryptophan-associated eosinophilia-myalgia syndrome and was treated with high doses of prednisone. This is the first reported case of adiposis dolorosa occurring as a complication of corticosteroid treatment. Alterations of fat metabolism induced by corticosteroid excess may have played a role in the development of this unusual painful syndrome. (Arch Dermatol. 1991;127:231-233) References 1. Dercum FX. Three cases of a hitherto unclassified affection resembling in its grosser aspects obesity, but associated with special symptoms: adiposis dolorosa . Am J Med Sci. 1982;104:521-535.Crossref 2. Bonatus TJ, Alexander AH. Dercum's disease (adiposis dolorosa): a case report and review of the literature . Clin Orthop Rel Res. 1986;205:251-253. 3. Blomstrand R, Juhlin L, Nordenstam H, Ohlsson R, Werner B, Engstrom J. Adiposis dolorosa associated with defects of lipid metabolism . Acta Derm Venereol (Stockh). 1971;51:243-250. 4. Eisman J, Swezey RL. Juxta-articular adiposis dolorosa: what is it? report of two cases . Ann Rheum Dis. 1979;38:479-482.Crossref 5. Steiger WA, Litvin H, Lasche EM, Durant TM. Adiposis dolorosa (Dercum's disease) . N Engl J Med. 1952;247:393-396.Crossref 6. Stallworth JM, Hennigar GR, Jonsson HT, Rodriguez O. The chronically swollen painful extremity . JAMA . 1974;228:1656-1659.Crossref 7. Peterson P, Kastrup J. Dercum's disease (adiposis dolorosa): treatment of the severe pain with intravenous lidocaine . Pain. 1987;28:77-80.Crossref 8. Scheinberg MA, Diniz R, Diamant J. Improvement of juxtaarticular adiposis dolorosa by fat suction . Arthritis Rheum. 1987;30:1435-1437.Crossref 9. Varga J, Peltonen J, Uitto J, Jimenez SA. Development of diffuse fasciitis with eosinophilia during L-tryptophan treatment: demonstration of elevated type 1 collagen gene expression in affected tissues: a clinicopathological study of four patients . Ann Intern Med. 1990;112:344-351.Crossref 10. Centers Control.ase Control. Eosinophilia-myalgia syndrome and L-tryptophan—containing products—New Mexico, Minnesota, Oregon, and New York . MMWR . 1989;38:785-788. 11. Slutsker L, Hoesly FC, Miller LM, Williams LP, Watson JC, Fleming DW. Eosinophilia-myalgia syndrome associated with exposure to tryptophan from a single manufacturer . JAMA . 1990;264: 213-217.Crossref 12. Silver R, Heyes P, Maize J, Querry B, Vionnet-Fuasset M, Sternberg E. Scleroderma, fasciitis, and eosinophilia associated with the ingestion of tryptophan . N Engl J Med. 1990;322:874-888.Crossref 13. Varga J, Heiman-Patterson D, Emery D, et al. Clinical spectrum of the systemic manifestations of the eosinophilia-myalgia syndrome. Semin Arthritis Rheum. 1990;19:313-328.Crossref 14. L-tryptophan: a `natural' sedative? Med Lett Drugs Ther. 1977;19:108. 15. Fries JF, Lindgren JA, Bull JM. Scleroderma-like lesions and the carcinoid syndrome . Arch Intern Med. 1973;131:550-553.Crossref 16. Stachow A, Jablonska S, Kencka D. Tryptophan metabolism in scleroderma and eosinophilic fasciitis . In: Black CM, Myers AR, eds. Current Topics in Rheumatology: Systemic Sclerosis (Scleroderma) . New York, NY: Gower Medical Publishers; 1985:130-134. 17. Cushing H. Basophil adenomas of the pituitary body and their clinical manifestations . Bull Johns Hopkins Hosp. 1932;50:137-195. 18. Seale PS, Compton MR. Side-effects of corticosteroid agents . Med J Aust. 1986;144:139-142. 19. Mayo-Smith W, Hayes CW, Biller BM, Klibanski A, Rosenthal H, Rosenthal D. Body fat distribution measured with CT: correlations in healthy subjects, patients with anorexia nervosa, and patients with Cushing's syndrome . Radiology . 1989;170:515-518.Crossref 20. Horber HH, Xurcher RM, Herren H, Crivelli MA, Robotti G, Frey FJ. Altered body fat distribution in patients with glucocorticoid treatment and in patients on long-term dialysis . Am J Clin Nutr. 1986;43:758-769. 21. Bachow TB, Hesselink JR, Aaron JO, Davis KR, Taveras JM. Fat deposition in the cavernous sinus in Cushing's disease . Radiology . 1984;153:135-136.Crossref 22. Gottlieb NL. Temporal fat pad sign during corticosteroid treatment . Arch Intern Med. 1980;140:1507-1508.Crossref 23. Brythian D, Piette C, Ducervean MN, Robert G, Godeau P, Heitz F. Steroid induced spinal epidural lipomatosis: CT survey . J Comput Assist Tomogr. 1988;12:501-503.Crossref 24. Ettinger WH, Goldberg AP, Appelbaum-Bowden D, Hazzard WR. Dyslipoproteinemia in systemic lupus erythematosus: effect of corticosteroids . Am J Med. 1987;83:503-508.Crossref 25. Zimmerman F, Fainura M, Eisenberg S. The effect of prednisone therapy on plasma lipoproteins and apoproteins: a prospective study . Metabolism. 1984;33:521-526.Crossref 26. Rebuffe-Scrive M. Steroid hormones and distribution of adipose tissue . Acta Med Scand Suppl. 1988;723:143-146. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Corticosteroid-Induced Juxta-articular Adiposis Dolorosa

Archives of Dermatology , Volume 127 (2) – Feb 1, 1991

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1991.01680020099013
Publisher site
See Article on Publisher Site

Abstract

Abstract • Long-term treatment with high doses of corticosteroids leads to the development of truncal obesity and focal fatty deposition. These deposits characteristically are located on the face, the nuchal and truncal areas, and episternally, as well as in the mediastinum and epicardium. We studied a patient with juxta-articular adiposis dolorosa who had L-tryptophan-associated eosinophilia-myalgia syndrome and was treated with high doses of prednisone. This is the first reported case of adiposis dolorosa occurring as a complication of corticosteroid treatment. Alterations of fat metabolism induced by corticosteroid excess may have played a role in the development of this unusual painful syndrome. (Arch Dermatol. 1991;127:231-233) References 1. Dercum FX. Three cases of a hitherto unclassified affection resembling in its grosser aspects obesity, but associated with special symptoms: adiposis dolorosa . Am J Med Sci. 1982;104:521-535.Crossref 2. Bonatus TJ, Alexander AH. Dercum's disease (adiposis dolorosa): a case report and review of the literature . Clin Orthop Rel Res. 1986;205:251-253. 3. Blomstrand R, Juhlin L, Nordenstam H, Ohlsson R, Werner B, Engstrom J. Adiposis dolorosa associated with defects of lipid metabolism . Acta Derm Venereol (Stockh). 1971;51:243-250. 4. Eisman J, Swezey RL. Juxta-articular adiposis dolorosa: what is it? report of two cases . Ann Rheum Dis. 1979;38:479-482.Crossref 5. Steiger WA, Litvin H, Lasche EM, Durant TM. Adiposis dolorosa (Dercum's disease) . N Engl J Med. 1952;247:393-396.Crossref 6. Stallworth JM, Hennigar GR, Jonsson HT, Rodriguez O. The chronically swollen painful extremity . JAMA . 1974;228:1656-1659.Crossref 7. Peterson P, Kastrup J. Dercum's disease (adiposis dolorosa): treatment of the severe pain with intravenous lidocaine . Pain. 1987;28:77-80.Crossref 8. Scheinberg MA, Diniz R, Diamant J. Improvement of juxtaarticular adiposis dolorosa by fat suction . Arthritis Rheum. 1987;30:1435-1437.Crossref 9. Varga J, Peltonen J, Uitto J, Jimenez SA. Development of diffuse fasciitis with eosinophilia during L-tryptophan treatment: demonstration of elevated type 1 collagen gene expression in affected tissues: a clinicopathological study of four patients . Ann Intern Med. 1990;112:344-351.Crossref 10. Centers Control.ase Control. Eosinophilia-myalgia syndrome and L-tryptophan—containing products—New Mexico, Minnesota, Oregon, and New York . MMWR . 1989;38:785-788. 11. Slutsker L, Hoesly FC, Miller LM, Williams LP, Watson JC, Fleming DW. Eosinophilia-myalgia syndrome associated with exposure to tryptophan from a single manufacturer . JAMA . 1990;264: 213-217.Crossref 12. Silver R, Heyes P, Maize J, Querry B, Vionnet-Fuasset M, Sternberg E. Scleroderma, fasciitis, and eosinophilia associated with the ingestion of tryptophan . N Engl J Med. 1990;322:874-888.Crossref 13. Varga J, Heiman-Patterson D, Emery D, et al. Clinical spectrum of the systemic manifestations of the eosinophilia-myalgia syndrome. Semin Arthritis Rheum. 1990;19:313-328.Crossref 14. L-tryptophan: a `natural' sedative? Med Lett Drugs Ther. 1977;19:108. 15. Fries JF, Lindgren JA, Bull JM. Scleroderma-like lesions and the carcinoid syndrome . Arch Intern Med. 1973;131:550-553.Crossref 16. Stachow A, Jablonska S, Kencka D. Tryptophan metabolism in scleroderma and eosinophilic fasciitis . In: Black CM, Myers AR, eds. Current Topics in Rheumatology: Systemic Sclerosis (Scleroderma) . New York, NY: Gower Medical Publishers; 1985:130-134. 17. Cushing H. Basophil adenomas of the pituitary body and their clinical manifestations . Bull Johns Hopkins Hosp. 1932;50:137-195. 18. Seale PS, Compton MR. Side-effects of corticosteroid agents . Med J Aust. 1986;144:139-142. 19. Mayo-Smith W, Hayes CW, Biller BM, Klibanski A, Rosenthal H, Rosenthal D. Body fat distribution measured with CT: correlations in healthy subjects, patients with anorexia nervosa, and patients with Cushing's syndrome . Radiology . 1989;170:515-518.Crossref 20. Horber HH, Xurcher RM, Herren H, Crivelli MA, Robotti G, Frey FJ. Altered body fat distribution in patients with glucocorticoid treatment and in patients on long-term dialysis . Am J Clin Nutr. 1986;43:758-769. 21. Bachow TB, Hesselink JR, Aaron JO, Davis KR, Taveras JM. Fat deposition in the cavernous sinus in Cushing's disease . Radiology . 1984;153:135-136.Crossref 22. Gottlieb NL. Temporal fat pad sign during corticosteroid treatment . Arch Intern Med. 1980;140:1507-1508.Crossref 23. Brythian D, Piette C, Ducervean MN, Robert G, Godeau P, Heitz F. Steroid induced spinal epidural lipomatosis: CT survey . J Comput Assist Tomogr. 1988;12:501-503.Crossref 24. Ettinger WH, Goldberg AP, Appelbaum-Bowden D, Hazzard WR. Dyslipoproteinemia in systemic lupus erythematosus: effect of corticosteroids . Am J Med. 1987;83:503-508.Crossref 25. Zimmerman F, Fainura M, Eisenberg S. The effect of prednisone therapy on plasma lipoproteins and apoproteins: a prospective study . Metabolism. 1984;33:521-526.Crossref 26. Rebuffe-Scrive M. Steroid hormones and distribution of adipose tissue . Acta Med Scand Suppl. 1988;723:143-146.

Journal

Archives of DermatologyAmerican Medical Association

Published: Feb 1, 1991

References