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Skin-nontumor / Clinical Dermatology

Other dermatoses

Panniculitis


Reviewer: Mowafak Hamodat, MB.CH.B, MSc., FRCPC, Eastern Health, St. Johns, Canada (see Reviewers page)
Revised: 1 August 2011, last major update August 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

Definition
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● Inflammation of subcutaneous fat affecting connective tissue septa separating lobules, usually in lower legs
● Poorly defined, tender, erythematous nodules
● Variable fever, malaise
● Lesions are transient
● Either septal (involving fibrous septa) or lobular (involving lipocyte lobules)
● Inadequate biopsy specimens, particularly punch biopsies, may include no subcutaneous fat, and make diagnosis difficult if not impossible

Lobular panniculitis: due to nodular vasculitis (erythema induratum), subcutaneous fat necrosis of newborn, pancreatic fat necrosis, lupus panniculitis, physical and factitious panniculitis, other
Lupus panniculitis: also called lupus profundus; may develop in normal skin or preexisting skin lesion of patient with systemic or discoid lupus erythematosus
Physical and factitious panniculitis: due to blunt force, pinching, cold or injection of foreign substances for secondary gain; a diagnosis of exclusion
Septal panniculitis: due to erythema nodosum or alpha-1-antitrypsin deficiency

Case reports
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● 45 year old woman (Dermatol Online J 2001;7:20)

Micro description
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Lupus panniculitis: ; vacuolar interface change and lymphoid infiltrates in dermis in lupus-related lesions; in non lupus-related skin lesions, see ghost cells due to loss of nuclei and basophilic material replacing cell membranes, causing basophilic sclerosis of lobules; dense lymphoplasmacytic infiltrates in lobules and septa; variable dermal and septal mucin; fibrosis over time
Septal panniculitis: lobular neutrophils, variable focal fat necrosis; refractile material may be present if substances were injected

End of Skin-nontumor / Clinical Dermatology > Other dermatoses > Panniculitis


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