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At least 163 records · Page 9Linked to original sources
PubMed2006

Connective tissue panniculitis in a child with vitiligo and Hashimoto's thyroiditis.

SUMMARY A 9-year-old girl presented with a 6-month history of inflamed tender nodules in the pretibial area. These eventually healed leaving depressed areas of atrophy and loss of subcutaneous tissue. Histology showed a predominantly lymphocytic lobular panniculitis, consistent with connective tissue panniculitis. Investigations revealed an elevated thyroid stimulating hormone, elevated thyroid antiperoxidase antibody and a weakly positive antinuclear antibody (titre 1 in 40). She was commenced on hydroxychloroquine 300 mg daily, which resulted in resolution of the panniculitis. She developed focal vitiligo on the thighs. This gradually improved with 0.1% mometasone furoate ointment. The hydroxychloroquine dose was tapered to 200 mg daily after 12 months, then to 100 mg daily after 18 months therapy. Her thyroid autoantibody levels continued to rise and the hydroxychloroquine was increased again to 300 mg daily. She became borderline hypothyroid. Hashimoto's thyroiditis was diagnosed. Thyroxine was instituted with a resultant improvement in her thyroid blood tests. The lipoatrophy has not developed further during 2-year follow up.

Biopsy, Needle↗
PubMed1986

Cytophagic panniculitis.

A 60 year old woman developed generalised erythema nodosum-like lesions together with hectic fever, lymphadenopathy, and hepatitis. Biopsies revealed lobular panniculitis with a benign histiocytic infiltrate and prominent phagocytosis in subcutaneous sites, lymph nodes, and bone marrow. All immunological, serological, and culture studies were negative, apart from throat isolation of herpes simplex. The patient responded to high-dose corticosteroids. The case illustrates the differential diagnosis of lobular panniculitis, with histiocytic infiltrate and cytophagocytosis. These combined features are consistent with the recently described syndromes of cytophagic panniculitis and virus-associated hemophagocytic syndrome.

Erythrocytes↗
PubMed2004

A case of subcutaneous panniculitis-like T-cell lymphoma with haemophagocytosis developing secondary to chemotherapy.

A 45-year-old woman presented with fever, generalized skin lesions and multiple lymphadenopathies. In her past history she had had six courses of cyclophosphamide and cisplatin combination chemotherapy 7 years ago because of an ovarian carcinoma. We found pancytopenia in the peripheral blood examination. Skin biopsy showed diffuse subcutaneous infiltration reminiscent of panniculitis but composed of malignant lymphoid cells that were of T lineage. Bone marrow biopsy showed normocellular myeloid tissue with abundant haemophagocytic macrophages. Subcutaneous panniculitis-like T-cell lymphoma with haemophagocytic syndrome was diagnosed. This is the first case reported of subcutaneous panniculitis-like lymphoma occurring secondary to chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Alpha 1-antitrypsin deficiency-associated panniculitis: case report and review of the literature.

Alpha 1-antitrypsin is the primary serum proteinase inhibitor. Alpha 1-antitrypsin deficiency, especially the ZZ genotype, has been linked mainly to emphysema and cirrhosis; it is also associated with paniculitis. A case of alpha 1-AT-associated panniculitis was documented in a 13-year-old girl in whom a deficiency of the enzyme was known to be present from infancy. This is unusual, since alpha 1-AT panniculitis previously was described in older patients without prior knowledge of the duration of the deficiency. Our patient developed erythematous, subcutaneous nodules subsequent to trauma, which later developed into deep, painless ulcers. We report this case so that the condition may be suspected in patients with panniculitis. The diagnosis may be confirmed by measuring quantitative alpha 1-AT serum levels and by enzyme genotyping. The treatment of choice is dapsone.

Adolescent↗
PubMed2001

Aggressive multiple myeloma presenting as mesenteric panniculitis.

Mesenteric panniculitis is a rare disease of the bowel mesentery, characterized by tumor-like infiltration by chronic inflammatory cells, fat necrosis, and fibrosis. Reported cases cited clinical presentation ranging from abdominal pain to fever of unknown origin, the majority of which were idiopathic and associated with a benign prognosis. We report the case of a 43-yr-old male who presented with malaise, weight loss, microcytic anemia, and a high erythrocyte sedimentation rate. Radiographic and histological investigations revealed typical features of mesenteric panniculitis. Initial treatment with high-dose oral prednisolone led to rapid and complete resolution of symptomatology, radiographic, and laboratory anomalies. Within 6 months, the patient presented again with anemia, renal failure, and hypercalcemia. A diagnosis of IgA kappa chain myeloma was made. Despite chemotherapy and restoration of normocalcemia, he died from refractory pulmonary edema. This is the first report of a hematological malignancy initially presenting with features of mesenteric panniculitis culminating in an aggressive course and a fatal outcome.

Adult↗
PubMed1993

Neutrophilic tuberculous panniculitis in a patient with polymyositis.

The clinical spectrum of cutaneous M. tuberculosis infections is varied and atypical. Once a major cause of death, with the advent of antimicrobial drugs it had, until recently, been an uncommon consideration in the differential diagnosis of cutaneous disorders. Panniculitis can be caused by a variety of etiologic agents; however, only rarely has it been reported caused by tuberculosis. Herein, we describe a patient with an unusual case of neutrophilic panniculitis caused by M. tuberculosis that arose following corticosteroid therapy for presumptive polymyositis. This case illustrates the need to include mycobacterial infection in the differential diagnosis of panniculitis in immunocompromised patients, and the importance of early detection via microbiologic culture and histopathologic examination.

Aged↗
PubMed1995

Sterile idiopathic pedal panniculitis in the German shepherd dog--clinical presentation and response to treatment of four cases.

Four cases of sterile idiopathic pedal panniculitis are described in the German shepherd dog. All the dogs presented with characteristic clinical signs of localised panniculitis dorsal to the midline of the carpal or tarsal pads of one or more legs. Diagnostic procedures did not identify a cause for the panniculitis and none of the cases had a history of penetrating foreign bodies. All cases failed to respond to antibiotic therapy but cases failed to respond to antibiotic therapy but did respond to anti-inflammatory doses of prednisone. The lesions in three dogs relapsed once the levels of steroids were reduced. However, in two of the cases oral vitamin E therapy at a dose of 300 iu twice daily acted in a steroid sparing capacity. In a fourth case, vitamin E acted to control the clinical signs without steroid therapy.

Animals↗
PubMed1974

Systemic nodular panniculitis with cardiac involvement.

A case of systemic nodular panniculitis is described in which the myocardium was found at necropsy to be extensively involved with focal interstitial carditis, identical histologically with nodules of panniculitis biopsied from the skin. This degree of myocardial involvement, which was not apparent during life and was not confined to pericardial or myocardial adipose tissue, has not previously been reported. The literature relating to nodular panniculitis is briefly reviewed and the concept of Weber-Christian disease critically re-appraised.

Adipose Tissue↗
PubMed2002

Chronic nodular panniculitis in a three-year-old mare.

The clinical signs of chronic nodular panniculitis in a three-year-old mare were consistent with a diagnosis of sterile nodular panniculitis, but the mare had histopathological signs of both generalised steatitis and sterile nodular panniculitis. The mare was deficient in vitamin E and selenium.

Animals↗
PubMed2002

Mesenteric panniculitis presenting with autoimmune haemolytic anaemia.

Mesenteric panniculitis is a rare idiopathic inflammatory disorder that can lead to sclerosis. We describe a patient with mesenteric panniculitis presenting with abdominal symptoms and autoimmune haemolytic anaemia. The symptoms remitted after splenectomy and gradual steroid taper. This may suggest an autoimmune component in the aetiology of mesenteric panniculitis.

Adult↗
PubMed2004

Pancreatic panniculitis in a patient with an acinar cell cystadenocarcinoma of the pancreas.

We describe a 60-year-old man with pancreatic panniculitis associated with arthritis and peripheral eosinophilia in whom the skin symptoms led to a diagnosis of an underlying acinar cell cystadenocarcinoma. The panniculitis involved initially the legs, but soon thereafter lesions developed on the trunk and upper extremities. In the literature, only 5 cases of pancreatic acinar cell cystadenocarcinoma have been reported, none of these in association with panniculitis.

Carcinoma, Acinar Cell↗
PubMed1992

Myalgia as the major symptom in systemic panniculitis (Weber-Christian disease).

A case of systemic panniculitis (Weber-Christian disease) presenting with myalgia as the main clinical symptom is reported. There was no laboratory or electromyographic evidence of myogenic disturbance. Biopsy of the painful muscle revealed nonspecific mononuclear cell infiltration in the epimysial fatty tissue, while the muscle fibers remained intact. Prednisolone was dramatically effective in alleviating the myalgia as well as the other signs of panniculitis. The present case may indicate that myalgia in systemic panniculitis is one manifestation of its systemic connective tissue involvement.

Adipose Tissue↗
PubMed1998

Septal panniculitis induced by atenolol--a case report.

The authors report a case of septal panniculitis induced by atenolol in a patient with coronary artery disease. Several tender, erythematous, suppurated subcutaneous nodules appeared over the metacarpal-phalanx and interphalanx joints of both hands. Hematology indicated a transient inflammatory immunomediated disorder, with an increase of cytotoxic suppressor lymphocytes and presence of antinuclear antibodies. The dramatic inflammatory involvement of the subcutaneous connective tissue could have eventually progressed toward fibrosis, if atenolol had not been withdrawn. This raises the possibility that retroperitoneal fibrosis, a recognized adverse effect of beta blockers, may just represent the terminal phase of undetected connective tissue inflammation occurring in districts not easily explorable before overt manifestations of the disease. Since retroperitoneal fibrosis has already been associated with migratory panniculitis and described as mesenteric panniculitis, it is tempting to speculate that these manifestations originate from the same mechanisms.

Adrenergic beta-Antagonists↗
PubMed2002

Mesenteric panniculitis associated with abdominal tuberculous lymphadenitis: a case report and review of the literature.

Mesenteric panniculitis is a rare disease characterized by chronic non-specific inflammation of the mesenteric adipose tissue. The specific aetiology of the disease is previously unknown. A case diagnosed as mesenteric panniculitis is presented. The cause was biopsy-proved abdominal tuberculous lymphadenitis. To our knowledge, mesenteric panniculitis associated with tuberculosis infection has not been reported previously in the literature. Thus, we would like to present the first case and describe CT features of the disease.

Humans↗
PubMed1997

[An adult case of dermatomyositis complicated with cecum perforation and panniculitis].

The case of dermatomyositis complicated with cecum perforation and panniculitis occurred in a 62-year-old woman was reported. She was admitted to Keio University Hospital with a history of proximal muscular weakness, and dysphagia. Physical examination showed erythema over the face and shoulder. Serum level of muscle enzymes was remarkably increased. The diagnosis of dermatomyositis was made based on proximal muscular weakness, elevated serum level of muscle enzymes and myogenic change of electromyocardiogram. The treatment with 60 mg/day of prednisolone was started, and was a good response. However, 7 months later the disease became active again when the amount of prednisolone was reduced to 13 mg/day. Subsequently she complained of abdominal pain on the right lower quadrant. The surgical findings included peritonitis due to the perforation of the cecum and multiple ulcers of the cecum. After operation, azathioprine was added. Four years and 9 months later, she noticed skin erythema with ulceration and subcutaneous nodule. Skin biopsy indicated the findings of the panniculitis with membrano-cystic lesion. It was thought that both cecum perforation and panniculitis were caused by angiopathy which was often seen in childhood dermatomyositis.

Cecal Diseases↗
PubMed2002

Subcutaneous panniculitis-like T-cell lymphoma: presentation of 2 cases and observations.

Subcutaneous panniculitis-like T-cell lymphoma is a rare tumor of primary cutaneous origin representing far < 1% of all non-Hodgkin's lymphomas. The disease typically follows a distinctive, indolent course of recurrent, self-healing subcutaneous nodules. These nodules mimic lipomas clinically, while histologically resembling a panniculitis. Alternatively, a rapidly progressive course might be seen with subcutaneous nodules accompanied by constitutional symptoms and, in some cases, the development of a potentially fatal hemophagocytic syndrome with significant cytopenia. This tumor is widely regarded as a tumor of CD8+ cytotoxic T cells with the presence of cytotoxic proteins, T-cell-restricted intracellular antigen, and granzyme B commonly demonstrated. A number of modalities have been reported in the treatment of this tumor, with varying degrees of success. In this report, we present 2 cases of subcutaneous panniculitis-like T-cell lymphoma with variable clinical courses. We also review the literature of this unusual lymphoma.

Adipocytes↗
PubMed2006

Subcutaneous panniculitis lymphoma: erythema nodosum-like.

We report the case of a patient who presented with painful nodular subcutaneous lesions on the lower limbs and episodes of high temperature (> 39.5 degrees C). Histologic examination and immunohistochemical study of a biopsy specimen from a nodular lesion were consistent with the diagnosis of subcutaneous panniculitis-like T-cell lymphoma, a rare form of non-Hodgkin lymphoma. Diagnosis is made particularly difficult, especially in the early stages, by nonspecific clinical features shared by many types of panniculitis. Therefore, it seems advisable to consider the possibility of this type of lymphoma in all cases of panniculitis and to perform careful and continuous follow-up of all cases in which a clear diagnosis is not formulated at the outset, with regular repetition of skin biopsies at appropriate intervals.

Adult↗
PubMed1999

Suppurative granulomatous eosinophilic panniculitis: case report.

A case of 12 year-old Nigerian male is presented. He had an unusual variant of Weber-Christian disease and manifested massive subcutaneous indurations and nodules limited to the cheeks, lips, left pectoral, infraclavicular and supraclavicular areas. A wedge biopsy revealed suppurative granulomatous eosinophilic panniculitis. Despite exhaustive investigations, no obvious trigger of the panniculitis could be identified. Response to corticosteroids and to empirical trials with other drugs was poor, and the outcome was fatal. We believe this is the first report from Nigeria of this rare variant of Weber-Christian panniculitis in the paediatric age, and draw attention to the life-threatening nature of this disorder.

Anti-Inflammatory Agents↗