Study of Clinical Profile Associated with Obesity amongst Dermatology Patients In A Tertiary Care Centre

Background: Obesity is a global epidemic. Obesity is associated with a number of dermatoses, including acanthosis nigricans, skin tag, keratosis pilaris, hyperandrogenism and hirsutism, striae distensae, and adiposis dolorosa. Objective: To elucidate the various skin changes in obesity and to determine if it is considered as an obesity marker. Methodology: 100 patients, aged 18 years or above satisfying the inclusion and exclusion criteria were drawn for a period of 18 months. Results: Out of 100 patients 54% were female, in their third and fourth decade. By occupation most of the females were housewives (40%) and the majority of males were farmers (14%). Type 2 diabetes mellitus was the most common systemic illness (24%). Pseudoacanthosis nigricans was the most prevalent skin change. 51% of patients had skin tags. 48% had striae distensae as a skin change. 10.86% male and 14.81% female patients had stasis dermatitis, 6% had leg venulectasias and 2% had leg ulcer. 26% had plantar hyperkeratosis. 41% of our patients had one or other types of fungal infections. Bacterial infections were detected in 15% cases, folliculitis being the commonest. Conclusion: Obesity is strongly related to several skin alterations that could be considered as markers of excessive weight. The dermatoses that showed a statistically significant relationship with obesity were Pseudo acanthosis nigricans, Skin tag, Striae, Plantar hyperkeratosis and Fungal infections. Prevention of obesity is important to prevent these dermatoses and dermatologists must work with primary care physicians and patients to reduce the harmful effects of obesity on the skin.

Dercum’s Disease: A Case Report of a Patient Having Both Type 1 and Type 2 Dercum’s Disease

Dercum’s disease, or adiposis dolorosa, is a rare disorder which consists of multiple, painful lipomas within the subcutaneous tissue and has a distribution mainly in the abdomen and extremities. Dercum’s disease can be defined as in combination with chronic painful adipose tissue. Although the etiology of Dercum’s disease is not clear, it is thought to be a combination of a neurological and endocrine disorder. Treatment for this disease is centered at managing pain. Although there is no standard of care for managing pain, there are different pain management regimes that are promising.

Dercum’s Disease: Estimating the prevalence of a rare painful loose connective tissue disease

Background In the United States (US), the Orphan Drug Act of 1983 defines a rare disease as affecting less than 200,000 individuals. In Europe, a rare disease or disorder is defined as affecting 5 individuals in 10,000 which the European commission reports to be approximately 246,000 individuals. Dercum’s disease, also known as Adiposis Dolorosa, is a rare loose connective (fat) tissue disease that is characterized by painful lipomas (fatty masses). Orphanet, the National Organization for Rare Disease (NORD) and the United States National Institutes of Health (NIH) have classified Dercum’s disease as a rare disorder. The prevalence of Dercum’s disease is not well studied or understood. The objective of this paper is to estimate the prevalence of Dercum’s disease, whether it is in fact a rare disease, and increase awareness for this painful disease. Results An in-depth literature review was conducted in PubMed, the UK Biobank, the U.S. Agency for Health Research and Quality Healthcare Cost and Utilization, by incidence of disease in medical practice, in social media forums and by internet search in order to understand, estimate and determine the prevalence of Dercum’s disease. The prevalence of Dercum’s disease was found to range from 150 to 150,000 in the US population. Conclusion The data collected in this paper meet the requirements of the Orphan Drug Act which requires 200,000 individuals or less to be affected by a disorder for it to be classified as rare. These conclusions may apply to Europe as supporting data was utilized from both Sweden and the UK. Further research must be conducted to better understand subclassifications of this rare disorder.