Panniculitis

Published on 05/03/2015 by admin

Filed under Dermatology

Last modified 05/03/2015

Print this page

This article have been viewed 2089 times

83

Panniculitis

Introduction

• Adipose tissue plays many active roles in the body beyond insulation, e.g. storing and releasing lipids, mediating inflammation, and modulating endocrinologic and reproductive systems.

• Panniculitis = inflammation of adipose tissue.

• Clinically and histopathologically, the adipose tissue has a limited repertoire of responses to insults and inflammation.

• Most often clinically presents as tender, inflamed, subcutaneous nodules or plaques; with the exception of erythema nodosum, ulceration with drainage may develop.

• There are various etiologies, and a clinical classification system is presented in Table 83.1.

Table 83.1

Clinical classification of the panniculitides.

^* The majority represent an underlying subcutaneous lymphoma.

• Diagnosis is challenging and involves consideration of (1) patient characteristics such as age, immune status, underlying diseases; (2) location of the lesions (Fig. 83.1); (3) the presence or absence of ulceration and/or drainage; and (4) histopathological findings.

Fig. 83.1 Most common locations for several forms of panniculitis.

• A biopsy is usually necessary to establish the diagnosis, and it is critical that the specimen include a generous portion of the subcutaneous (SC) fat.

• Excisional biopsies or narrow incisional biopsies that incorporate a broad expanse of SC fat are preferable to punch biopsies.

• Once the diagnosis of panniculitis is made, further evaluation for underlying etiology or associated conditions is necessary (Tables 83.2–83.4).

Table 83.2

The more common panniculitides.

Buy Membership for Dermatology Category to continue reading. Learn more here

Related

Dermatology Essentials E- Book