Recurrent lipoatrophic panniculitis of children

Area of Science:

• Pediatric Dermatology
• Immunology
• Rheumatology

Background:

• Recurrent panniculitis with lipoatrophy in children is poorly defined and lacks systematic immunohistochemical evaluation.
• Previous reports used varied terminology, hindering a clear understanding of this condition.

Purpose of the Study:

• To systematically evaluate the clinical, histopathological, and immunohistochemical profile of children experiencing recurrent idiopathic panniculitis.
• To characterize the inflammatory processes and cellular infiltrates involved in pediatric panniculitis and lipoatrophy.

Main Methods:

• A retrospective review of five pediatric cases with recurrent idiopathic panniculitis and lipoatrophy.
• Detailed analysis of clinical presentations, laboratory findings, histopathology, and immunohistochemistry (including myeloperoxidase, CD68/PGM1, and STAT1 staining).

Main Results:

• Patients presented with painful subcutaneous nodules, fever, malaise, abdominal pain/arthralgia, and subsequent lipoatrophy.
• Histopathology revealed lobar panniculitis with a mixed inflammatory infiltrate; immunohistochemistry showed specific markers for neutrophils, myeloid cells, and macrophages at different stages.
• Laboratory findings included elevated acute phase reactants, leukocytosis, anemia, and elevated liver enzymes.

Conclusions:

• This study describes five cases of childhood lobar panniculitis with lipoatrophy, highlighting a distinct clinico-pathologic entity.
• The findings suggest that recurrent idiopathic panniculitis in children may represent a form of autoinflammatory disease, warranting further investigation.