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Acute panniculitis: a clinical and histopathologic study of 34 cases
Abstract:
Thirty-four patients had histopathologic findings of acute panniculitis. 15 had clinical findings of erythema nodosum; 6 had infectious lesions; and 5 had Weber-Christian-like conditions with recurrent febrile suppurative or nonsuppurative nodular eruptions; 3 of the 5 had amylase and lipase enzyme abnormalities with or without pancreatic disease. Five additional patients had acute panniculitis that would be termed "deythema induratum" or "nodular vasculitis" by most clinicians, and the subsequent pathologic findings and courses were consistent with this view. Two patients had limited, traumatic panniculitis, forming a distinctive group, but trauma was a factor in lesion formation in all groups, and one patient had vasculitis. Whereas acute panniculitis, with or without fat necrosis, may be associated with many inflammatory syndromes of the skin and subcutaneous tissue and may rarely occur in all, the most common relationship is with erythema nodosum in its most acute forms.
Insights
Acute panniculitis, a skin inflammation, commonly presents with erythema nodosum. Trauma is a frequent factor across various panniculitis presentations, including Weber-Christian-like conditions.
Area of Science:
- Dermatology
- Pathology
Background:
- Acute panniculitis encompasses diverse histopathologic findings.
- Understanding its varied clinical presentations is crucial for diagnosis.
Observation:
- Thirty-four patients exhibited acute panniculitis.
- Common associations included erythema nodosum (15 patients), infectious lesions (6), and Weber-Christian-like conditions (5).
- Specific subtypes like erythema induratum/nodular vasculitis and traumatic panniculitis were also identified.
Findings:
- Trauma played a role in lesion formation across all observed groups.
- Three patients with Weber-Christian-like conditions showed amylase/lipase abnormalities, suggesting potential pancreatic involvement.
- Acute panniculitis is most frequently linked to erythema nodosum, though it can occur with various inflammatory syndromes.
Implications:
- This study highlights the diverse etiology and clinical spectrum of acute panniculitis.
- Recognizing the common association with erythema nodosum and the potential role of trauma is key.
- Further investigation into associated systemic conditions, like pancreatic abnormalities, is warranted.