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Therapeutics in Dermatology
A reference textbook in dermatology

Panniculitis

18 April 2012, by BATTISTELLA M.

Summary

The term panniculitis refers to an inflammation of the subcutaneous fat. The panniculitides represent a group of heterogeneous diseases whose prognosis and treatment differ depending on the specific diagnosis. The common feature of all these diseases is inflammation of subcutaneous adipose tissue (panniculus adiposus).

The panniculitides present clinically as inflammatory nodules, usually involving the legs and thighs, but which can also be present on the arms, abdomen, buttocks and breasts. Involvement of the face is extremely rare.

These nodules are deep, palpable and sometimes painful “bumps”, measuring at least 2 cm across. The overlying skin is red.

The nodules may be accompanied by fever, joint pain or other symptoms associated with the causal disease. Ulceration of the skin overlying the nodules may occur, giving rise to a discharge.

A specific diagnosis requires biopsy (removing a sample of skin) under local anesthesia. More than one skin biopsy may be required in difficult-to-diagnose cases. Blood tests and imaging studies may also be prescribed.

Cases with a difficult diagnosis often take a chronic course, with periods of improvement alternating with flare-ups, in spite of treatment. 

Large-scale scientific studies have not reached a validated consensus regarding the therapeutic strategy or treatment. Treatments are considered on a case by case basis with the physician, depending on the diagnosis and the individual characteristics of the patient.

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