The most common panniculitis in rheumatology practice
Authors:
R. Moravcová
Authors‘ workplace:
Revmatologický ústav Praha
Published in:
Čes. Revmatol., 31, 2023, No. 4, p. 172-182.
Category:
Review Article
Overview
Panniculitis is one of the most challenging areas for all clinicians because it is a very heterogeneous group of inflammatory diseases with similar clinical and histopathological features that affect the subcutaneous fat. Clinically, they manifest as red edematous nodules and plaques. In addition to a detailed anamnesis, a biopsy of the lesion with an adequate representation of the subcutaneous tissue is necessary to determine the diagnosis and subsequently to start appropriate treatment. According to the place of origin and type of inflammatory infiltrate and the presence of vasculitis, we divide panniculitis into several groups. In this review, we will mainly focus on panniculitis without vasculitis, namely those that are of particular interest to rheumatologists, who see it most often in their offices.
Keywords:
panniculitis – septal panniculitis – lobular panniculitis – mixed panniculitis – panniculitis without vasculitis
Sources
1. Svačina Š. Röhm KH. Poruchy metabolismu a výživy. Praha: Galén 2010.
2. Segura S, Requena L. Anatomy and histology of normal subcutaneous fat, necrosis of adipocytes, and classification of the panniculitides. Dermatol Clin 2008; 26: 419–424.
3. Velasco LM, Pérez-Gónzalez YC, Kempf W, et al. Clues in histopathological diagnosis of panniculitis. Am J Dermatopathol 2018; 40: 155–167.
4. Chowaniec M, Starba A, Wiland P. Erythema nodosum – review of the literature. Reumatologia 2016; 54: 79–82.
5. Requena L, Yus ES. Erythema Nodosum. Dermatol Clin 2008; 26: 425–438.
6. Requena L, Yus ES. Panniculitis. Part I. Mostly septal panniculitis. J Am Acad Dermatol 2001; 45: 163–183.
7. García-Porrúa C, López-Lazaro L, Lueiro M, et al. Erythema nodosum: etiologic and predictive factors in a defined population. Arthritis Rheum 2000; 43: 584–592.
8. Mert A, Ozaras R, Tabak F, et al. Erythema nodosum: an experience of 10 years. Scand J Infect Dis 2004; 36: 424–427.
9. Psychos DN, Voulgari PV, Skopouli FN, et al. Erythema nodosum: the underlying conditions. Clin Rheumatol 2000; 19: 212–216.
10. Ziemer M, Muller AK, Hein G, et al. Incidence and classification of cutaneous manifestations in rheumatoid arthritis. J Dtsch Dermatol Ges 2016; 14: 1237–1246.
11. Tilstra JS, Lienesch DW. Rheumatoid Nodules. Dermatol Clin 2015; 33: 361–371.
12. Chua-Aguilera CJ, Moller B, Yawalkar N. Skin manifestations of rheumatoid arthritis, juvenile idiopathic arthritis, and Spondyloarthritides. Clin Rev Allergy Immunol 2017; 53(3): 371–393.
13. Walker D, Susa JS, Currimbhoy S, et al. Histopathological changes in morphea and their clinical correlates: results from the Morphea in adults and children cohort V. J Am Acad Dermatol 2017; 76: 1124–1130.
14. Shiau CJ, Abi Daoud MS, Wong SM, et al. Lymphocytic panniculitis: an algorithmic approach to lymphocytes in subcutaneous tissue. J Clin Pathol 2015; 68: 954–962.
15. Fett N, Werth VP. Update on morphea: Part I. Epidemiology, clinical presentation, and pathogenesis. J. Am. Acad. Dermatol 2011; 64: 217–228.
16. Evangelisto A, Werth V, Schumacher HR. What is that nodule? – a diagnostic approach to evaluating subcutaneous and cutaneous nodules. J Clin Rheumatol 2006; 12: 230–240.
17. Lee P. Eosinophilic fasciitis: new associations and current per-spectives [editorial]. J Rheumatol 1981; 8: 6–8.
18. Naschitz JE, Boss JH, Misselvich I, et al. The fasciitis-panniculitis syndromes: clinical and pathological fea- tures. Medicine 1996; 75: 6–16.
19. Weber FP. A case of relapsing non-suppurative nodular panniculitis showing phagocytosis of subcutaneous fat-cells by macrophages. Br J Dermatol Syphilis 1925; 301–311.
20. White JW Jr, Winkelmann RK. Weber-Christian panniculitis: a review of 30 cases with this diagnosis. J Am Acad Dermatol 1998, 39: 56–62.
21. Brown R, Buckley R, Keley M. Pancreatic panniculitis. J Clin Oncol 1997; 15: 3418–3419.
22. López A, García-Estan J, Marras C, et al. Pancreatitis associated with pleural-mediastinal pseudocyst, panniculitis and polyarthritis. Clin Rheumatol 1998; 17: 335–339.
23. Francombe J, Kingsnorth AN, Tunn E. Panniculitis arthritis and pancreatitis. Br J Rheumatol 1995; 34: 680–683.
24. Smith KC, Pittelkow MR, Su WPD. Panniculitis associated with severe alpha-1-antitrypsin deficiency: treatment and review of the literature. Arch Dermatol 1987; 123: 1655–1661.
25. Bassett LW, Gold RH, Coive HC. Mammographic spectrum of traumatic fat necrosis: the fallibility of „pathognomonic“ signs of carcinoma. Am J Roentgenol 1978; 130: 119–122.
26. Requena L, Yus ES. Panniculitis. Part II. Mostly lobular panniculitis. J. Am Acad Dermatol 2001; 45: 325–361.
27. Tuffanelli DL. Lupus Erythematosus Panniculitis (Profundus). Arch. Dermatol 1971; 103: 231.
28. Ng PP-L, Tan SH, Tan T. Lupus erythematosus panniculitis: a clinicopathologic study. Int J Dermatol 2002; 41: 488–490.
29. Park HS, Choi JW, Kim B, et al. Lupus erythematosus panniculitis: Clinicopathological, Immunophenotypic, and molecular studies. Am J Dermatopathol 2010; 32: 24–30.
30. Michot C, Costes V, Gerard-Dran D, et al. Subcutaneous panniculitis-like T-cell lymphoma in a patient receiving etanercept for rheumatoid arthritis. Br J Dermatol 2009; 160: 889–890.
31. Molnar K, Kemeny L, Korom I, et al. Panniculitis in dermatomyositis: report of two cases. Br J Dermatol 1998; 139: 161–163.
32. Winkelmann RK. Panniculitis in connective tissue disease. Arch Dermatol 1983; 119: 336–344.
33. Ochoa CD, Valderrama V, Mejia J, et al. Panniculitis: another clinical expression of gout. Rheumatol Int 2011; 31: 831–835.
34. Torrelo A, Hernández A. Panniculitis in Children. Dermatol Clin 2008; 26: 491–500.
35. Kim ST, Kim TK, Lee JW, et al. Post-steroid panniculitis in an adult. J Dermatol 2008; 35: 786–788.
36. Chan MP. Neutrophilic panniculitis: algorithmic approach to a heterogeneous group of disorders. Arch Pathol Lab Med 2014; 138: 1337–1343.
37. Morita TCAB, Trés GFS, García MSC, et al. Panniculitides of particular interest to the rheumatologist. Adv Rheumatol 2019; 59(1): 35.
38. Misago N, Tada Y, Koarada S, et al. Erythema nodosum-like lesions in Behçeťs disease: a clinicopathological study of 26 cases. Acta Derm Venereol 2012; 92: 681–686.
39. Gilchrist H, Patterson JW. Erythema nodosum and erythema induratum (nodular vasculitis): diagnosis and management. Dermatol Ther 2010; 23(4): 320–327.
40. Pongratz G, Ehrenstein B, Hartung W, et al. A patient with Pfeifer-Weber-Christian disease--successful therapy with cyclosporin A: case report. Musculoskelet Disord 2010: 11: 18.
41. Blake T, Manahan M, Rodins K. Erythema nodosum – a review of an uncommon panniculitis Dermatol Online J 2014 ;20(4): 223–276.
42. Boyd AS. Etanercept treatment of erythema nodosum. Skinmed 2007; 6: 197–199.
43. Quin A, Kane S, Ulitsky O. A case of fistulizing Crohn’s disease and erythema nodosum managed with adalimumab. Nat Clin Pract Gastroenterol Hepatol 2008; 5: 278–281.
Labels
Dermatology & STDs Paediatric rheumatology RheumatologyArticle was published in
Czech Rheumatology
2023 Issue 4
Most read in this issue
- The most common panniculitis in rheumatology practice
- Rheumatoid arthritis therapy and liver disease
- CONTENT 2023
- Subcutaneous infliximab CT-P13: biobetter for the use in rheumatology