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Panniculitis

Inflammation of the subcutaneous fat with multiple etiologies

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dermatoloji department. Book Appointment →

What is Panniculitis?

Panniculitis is a group of heterogeneous inflammatory disorders affecting the subcutaneous fat (panniculus adiposus), classified histologically as septal, lobular or mixed and further subdivided by presence or absence of vasculitis. The clinical presentation is similar across subtypes: erythematous, tender, deep cutaneous nodules, most commonly on the lower extremities.

Septal panniculitis without vasculitis includes erythema nodosum (the most common form). Lobular forms include erythema induratum (nodular vasculitis), pancreatic panniculitis, alpha-1 antitrypsin deficiency panniculitis and lupus panniculitis. Diagnosis requires deep incisional biopsy including subcutaneous fat for proper architecture evaluation.

Symptoms

Tender erythematous subcutaneous nodules
Predilection for the shins and lower extremities
Bilateral and symmetric distribution
Bruise-like appearance as lesions resolve
Fever and arthralgia in erythema nodosum
Ulceration in erythema induratum
Pain with palpation
Variable size from 1-5 cm

Risk Factors

Streptococcal infection (erythema nodosum)
Inflammatory bowel disease
Sarcoidosis
Tuberculosis (erythema induratum)
Pancreatic disease (pancreatic panniculitis)
Alpha-1 antitrypsin deficiency
Lupus erythematosus
Drugs (oral contraceptives, sulfonamides)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent tender skin nodules
  • Bruise-like lesions on the shins
  • Nodules with fever or joint pain
  • Ulcerated subcutaneous nodules
  • New nodules with abdominal pain (consider pancreatic)
  • Recurrent crops of subcutaneous lesions
  • Nodules associated with breathing or systemic symptoms

Treatment Methods

01
Deep incisional biopsy including fat for histopathologic classification
02
Identification and treatment of underlying cause (infection, IBD, sarcoidosis)
03
Bed rest, leg elevation and compression for symptomatic relief
04
NSAIDs (indomethacin, naproxen) for erythema nodosum
05
Potassium iodide saturated solution for nodular vasculitis
06
Systemic corticosteroids for severe or refractory disease
07
Hydroxychloroquine for lupus panniculitis
08
Anti-TNF biologics for IBD-associated cases
09
Tuberculosis treatment when M. tuberculosis is implicated

Which Department to Visit?

You can visit our Dermatoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.