Presenter: Rachel Cetta DO, Sonam Rama DO
Dermatology Program: SCS/MSUCOM/Beaumont Hospital-Trenton
Program Director: Steven Grekin DO
Submitted on: May 5, 2017
CHIEF COMPLAINT: A 55-year-old female was referred to our office complaining of painful nodules located on her back and arms.
CLINICAL HISTORY:
Signs and symptoms: The patient reported the lesions on her upper extremities and trunk had been present for forty plus years and had endured twenty-four excisions to remove these nodules. Patient stated the nodules were tender to palpation and would get severe sharp shooting pain in these lesions.
Previous Treatment: Patient had tried gabapentin but it caused her to have dizziness, and patient was currently being treated with pregabalin (50 mg BID) for alleviation of pain. This did control the pain at times, but did not take it away completely.
Other information: PMHx: Bipolar disorder, osteoarthritis, pulmonary embolism, deep vein thrombosis, breast cancer, depression
Medications:
Lithium, valproic acid, quetiapine, lorazepam, pregabalin, baclofen and oxycodone with acetaminophen (as needed)
PHYSICAL EXAM:
On physical exam, multiple squishy subcutaneous nodules on bilateral arms with scars were noted as well as multiple subcutaneous nodules on the back with scars.
LABORATORY TESTS:
none
DERMATOHISTOPATHOLOGY:
none
DIFFERENTIAL DIAGNOSIS:
1. Adiposis Dolorosa (Decrum’s Disease)
2. Familial multiple lipomatosis
3. Madelung’s disease
4. Proteus Syndrome
5. Gardner Syndrome
I have a lot of problem with this disease and I don’t know where I’m gonna get it in my body so they’re giving me some medicine but it’s not helping me at all I have a lot of pain in my back II need in my hip so I have hard time to get up from my bed and go to work and do my job I feel always tired 😫