Neutrophilic panniculitis M79.3

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Neutrophilic lobular panniculitis; Neutrophilic panniculitis; Neutrophil paniculitis; Panniculitis neutrophilic lobular

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Polyätiological panniculitis in existing myelodysplastic syndrome or rheumatoid arthritis; also occurring as ADR in therapy with BRAF inhibitors, e.g. vemurafenib.

Furthermore, the syndrome has been observed in autoinflammatory syndromes such as Sweet's syndrome and Crohn's disease as well as in hereditary alpha-1-antitrypsin deficiency.

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Mainly occurring in middle-aged women.

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The lower leg.

Clinical features
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Painful nodules and plates in the subcutis with red, overlying skin.

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Signs of inflammation with BSG and CRP elevation, leukocytosis and neutrophilia.

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Diffuse lobular fat tissue necrosis with basophilic necrosis, dense infiltrates with neutrophilic granulocytes, foam cells. Perivascularly, some lymphocyte infiltrates are also visible. Lipomembranous fat cell necrosis and micropseudofattysts are also present in the lobular periphery.

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Treatment of the underlying disease. Rapid response to systemic glucocorticoids. Symptomatic local therapy. Reduction of therapy with BRAF inhibitors.

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  10. Kim GH et al (2014) Neutrophilic panniculitis developing after treatment of metastatic melanoma with vemurafenib. J Cutan catheter 40:667-669
  11. Kim J et al (2010) A case of Sweet's Panniculitis Associated with Spinal Metastasis from Prostate Cancer. Ann Dermatol 22:478-481
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  13. Monfort JB et al (2012) Vemurafenib-induced neutrophilic panniculitis. Melanoma Res 22:399-401


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Last updated on: 29.10.2020