Aesthetic Thermotherapy-Induced Panniculitis in a Patient with Psoriasis: A Case Report

We describe a rare case of panniculitis following aesthetic thermotherapy in a patient with psoriasis, who responded well to tofacitinib. To the best of our knowledge, this is the first reported case of aesthetic thermotherapy-induced panniculitis in a patient with psoriasis.

A 39-year-old female with a 4-year history of psoriasis vulgaris developed multiple subcutaneous nodules on the extremities and abdomen one month after completing a one-week course of whole-body aesthetic thermotherapy (approximately 40-50 ^° C, approximately one hour per session). Physical examination revealed firm, mobile, mildly tender nodules, with the largest measuring 5 cm in diameter and overlying skin appearing normal or slightly reddish. Laboratory investigations to exclude other causes of panniculitis, including autoimmune markers and infection screening, were unremarkable except for an elevated C-reactive protein level (118.6 mg/L). Ultrasound demonstrated subcutaneous inflammatory changes, and percutaneous biopsy confirmed chronic inflammation with histiocytic infiltration, consistent with panniculitis. The patient was treated with oral tofacitinib (5 mg once daily) for six months, resulting in significant clinical improvement during follow-up; the underlying psoriasis remained stable.

Aesthetic thermotherapy can rarely induce panniculitis, especially in patients with underlying psoriasis and immune dysregulation. This case highlights the need to consider panniculitis when patients present with new subcutaneous nodules after cosmetic thermal procedures. Tofacitinib appears to be an effective treatment option.