DefinitionThis section has been translated automatically.
Polyaetiological, heterogeneous group of mostly localised, rarely generalised, inflammatory diseases of the adipose tissue (panniculus = lobules) in which a phasic, reactive inflammatory process takes place, which ends either in a restitutio ad integrum or in scarring defect healing (adipose tissue atrophy), recognisable by retracted defects of the skin surface.
There is no generally accepted classification of panniculitis, so all classificatory approaches have always been provisional.
For example, different names are used by clinicians and pathologists for the same clinical picture (erythema induratum vs nodular vasculitis).
Also, older terminology has become obsolete, such as " panniculitis nodularis nonsuppurativa febrilis et recidivans".
On the basis of new findings, it can be assumed that the term panniculitis nodularis nonsuppurativa febrilis et recidivans conceals several distinct clinical pictures, such as AAT deficiency-associated panniculitis, pancreatic panniculitis or lupus panniculitis. The present classification is based primarily on histological criteria (septal vs. lobular; with vasculitis vs. without vasculitis), and secondarily on etiological (traumatic, infectious, articular) criteria. However, it must be clarified that the subdivision into septal and lobular panniculitis is often difficult, since pure forms are rather rare and mixed pictures are the rule.
ClassificationThis section has been translated automatically.
- Without vasculitis:
- Panniculitis nodularis nonsuppurativa febrilis et recidivans (Pfeiffer-Weber-Christian syndrome)
- Lipogranulomatosis subcutanea
- Pancreatic panniculitis
- Physical/traumatic/artificial panniculitis:
- Panniculitis, with "needle shaped clefts" in lipocytes:
- Lobular panniculitis in collagenoses:
- Lobular panniculitis in other diseases:
- Panniculitis in malignant systemic diseases:
- Panniculitis due to infections:
- With vasculitis:
- Erythema induratum Bazin (nodular vasculitis).
- Without vasculitis:
- With vasculitis:
* Exclusively lobular or septal panniculitis are not observed. Thus, both terms should be understood as "predominantly septal" or "predominantly lobular".
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EtiopathogenesisThis section has been translated automatically.
LocalizationThis section has been translated automatically.
Clinical featuresThis section has been translated automatically.
HistologyThis section has been translated automatically.
See under the individual clinical pictures. The biopsy of an older panniculitis is worthless. To obtain representative material, a deep biopsy of a fresh lesion (first clinical manifestations) is required. In longer-standing panniculitis, resorptive inflammatory reparative processes override the initiating process. These reparative processes are largely identical histomorphologically for all forms of panniculitis and are therefore diagnostically inconclusive. The biopsy must be performed as a wide excision biopsy as "atraumatically" as possible and extend to the muscle fascia. Punch biopsies are not indicated because of the lack of depth of the excision.
DiagnosisThis section has been translated automatically.
TherapyThis section has been translated automatically.
LiteratureThis section has been translated automatically.
- Ferrara G et al (2013) Panniculitis with vasculitis. G Ital Dermatol Venereol 148:387-394
- Grassi S et al (2013) Panniculitis in children. G Ital Dermatol Venereol 148:371-385
- Kolb-Mäurer A (2015) Panniculitis in pancreatitis.JDDG 13: 807-809.
- Passarini B et al (2013) Erythema nodosum. G Ital Dermatol Venereol148:413-417 Review. PubMed PMID: 23900162.
- Patterson JW (2003) Panniculitis. In: Bologna JL et al (eds) Dermatology, Mosby London New York Toronto, pp 1551-1552.
- Perasole A (2013) Infectious panniculitides: an update. G Ital Dermatol Venereol 148:427-433
- Rongioletti F et al (2013) Pancreatic panniculitis. G Ital Dermatol Venereol 148:419-425
Xiao W et al (2021) Panniculitis caused by progesterone injection can be treated by physical therapy. Dermatol Ther 34:e14501.
Incoming links (26)Acne conglobata infantum; Artifacts; Artifacts; Aspergillosis disseminated; Basidiomycosis; BTK-inhibitor; Calciphylaxis; Eosinophilic panniculitis; Erythema nodosum; Erythrocyanosis crurum puellarum; ... Show all
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