Pancreatic Panniculitis: A Rare Sign of a Common Disease

Pancreatic panniculitis is a rare form of panniculitis that occurs in a minority of patients with pancreatic disease, including malignancy. We present the case of a 51-year-old male patient admitted to the hospital with acute gallstone pancreatitis. During his admission, he reported the appearance of painful subcutaneous erythematous nodules on his lower limbs. A skin biopsy was done, revealing the presence of "ghost adipocytes," compatible with pancreatic panniculitis. Although the pathogenesis is unknown, it is thought to be associated with circulating pancreatic enzymes and clinically presents with subcutaneous erythematous to brownish nodules, mostly on the lower limbs, that typically resolve with the underlying disease. With the high prevalence of pancreatic disorders, it is very important that clinicians recognize associated skin lesions, as these may even be the presenting symptom of an underlying pancreatic pathology.