[Panniculitis in a 32-year-old man]

The term panniculitis refers to a heterogeneous category of conditions characterized by inflammation of subcutaneous adipose tissue. We report on a 32-year-old man who developed severe panniculitis with subsequent lipoatrophy. The disease initially presented as moderately painful subcutaneous nodules associated with general symptoms (fever, malaise, musculoskeletal symptoms). As the symptoms exacerbated despite treatment with antibiotics and nonsteroidal anti-inflammatory drugs, the patient was referred to a dermatology unit. Erythema nodosum was suspected and some transient improvement was obtained with intravenous antibiotics and glucocorticoids. However, the symptoms reappeared shortly after the patient's discharge from hospital.

For this reason, the patient was readmitted to the hospital and then transferred to a diagnostic unit. Diagnosis of panniculitis was confirmed by biopsy of subcutaneous tissue. However, no definite diagnosis of the underlying pathology could be made despite a broad array of diagnostic tests performed.

The treatment with high-dose glucocorticoids was ineffective. Eventually, remission was achieved with oral azathioprine.