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Drug-induced panniculitides.

G Borroni1, S Torti, R M D'Ospina

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Drug-induced panniculitis, including erythema nodosum (EN), is often overlooked. Establishing a drug link requires a history of intake and improvement after discontinuation, as features mimic other causes.

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Area of Science:

  • Dermatology
  • Pharmacology
  • Pathology

Background:

  • Panniculitides are inflammatory conditions of subcutaneous fat, often lacking a clear etiology.
  • Erythema nodosum (EN) is a common panniculitis where drug induction is underrecognized.
  • Drug-induced panniculitides share clinical and histopathological features with other causes, complicating diagnosis.

Purpose of the Study:

  • To review reported cases of drug-induced panniculitis, focusing on erythema nodosum.
  • To highlight the diagnostic challenges and the importance of drug history and withdrawal.
  • To emphasize the need for vigilance regarding new drug classes as potential inducers.

Main Methods:

  • Review of existing literature on drug-induced panniculitis.
  • Inclusion of illustrative original case observations.
  • Analysis of clinical and histopathological data where available.

Main Results:

  • Erythema nodosum (EN) is the most frequently reported drug-induced panniculitis.
  • Commonly implicated drugs include oral contraceptives, NSAIDs, antibiotics, and leukotriene modifiers.
  • Diagnosis is often clinical, lacking histopathological confirmation, hindering precise clinicopathological correlation.

Conclusions:

  • Drug-induced panniculitis requires careful consideration of medication history and response to discontinuation.
  • The diverse range of causative drugs complicates understanding the underlying pathogenesis.
  • Ongoing monitoring for new drug-induced panniculitides is crucial, especially with novel therapeutics.