A case of deadly panniculitis.

Area of Science:

• Dermatology
• Immunology
• Pathology

Background:

• Panniculitis, inflammation of subcutaneous fat, is typically benign.
• However, it can rarely indicate serious underlying systemic conditions.
• Early differentiation between benign and malignant causes is critical for patient outcomes.

Observation:

• A case initially diagnosed as lupus profundus panniculitis presented with evolving features.
• These features suggested a concurrent diagnosis of haemophagocytic lymphohistiocytosis (HLH).
• This highlights the diagnostic challenge when panniculitis masks complex systemic disease.

Findings:

• Key clinical signs and symptoms were crucial in identifying the progression of the disease.
• Advanced diagnostic investigations aided in distinguishing between benign and malignant processes.
• The case underscores the importance of a comprehensive diagnostic approach.

Implications:

• This case emphasizes the need to consider systemic diseases beyond lupus profundus when evaluating panniculitis.
• It highlights the utility of newer diagnostic tools in identifying rare, aggressive conditions like HLH.
• Accurate differentiation can lead to timely and appropriate treatment, improving prognosis for patients with complex panniculitis.