Panniculitis

General Information
Panniculitis is an inflammation within adipose tissue. Clinically, individuals present with tender nodular lesions typically on the calves or shins that feel thickened and woody. A microscopic evaluation divides panniculitis into four subtypes. Lobular with vasculitis e.g. Erythema nodosum leprosum (leprosy), Lucio’s phenomenon; Lobular panniculitis without vasculitis e.g. Scelerosing panniculitis (lipodermatosclerosis), Calciphylaxis; Septal panniculitis with vasculitis e.g. Leukocytoclastic vasculitis, Superficial thrombophlebitis; Septal panniculitis without vasculitis e.g. Necrobiosis lipoidica, scleroderma, which may be localized (morphea). When the inflammation has subsided, a depression in the skin may be left in the affected area. Treatment includes rest and elevation, compression hosiery, anti-inflammatory medication and antibiotics, systemic steroids, potassium iodide or surgical removal of lesions.

Epidemiology
Peak age of 25-40, Female: Male ratio 4:1

Etiology
Without systemic disease e.g. trauma, cold. With systemic disease e.g. collagen vascular disease, lymphoma.

Pathogenesis
Single or multiple crops of nodules in subcutaneous fat

Clinical
Nodular lesions throughout body

Histology
Inflammation primarily in the septa is designated septal panniculitis, whereas inflammatory cells primarily in the fat lobules designate lobular panniculitis.

Bibliography
1. “Panniculitis” (Online). March 2007. http://dermnetnz.org/dermal-infiltrative/panniculitis.htmlhtml (visited: April 1, 2008) 2. “Panniculitis” (Online). http://www.healthcentral.com/encyclopedia/408/175.html (visited: April 1, 2008)

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 Panniculitis