« Back to Inflammatory Disorders

Panniculitis

»What is panniculitis?
»Name the various types of panniculitis. How are they classified?
»What is erythema nodosum?
»What is the pathogenesis of erythema nodosum?
»List some of the common underlying conditions associated with erythema nodosum.
»How should a biopsy of erythema nodosum be obtained?
»What are the characteristic microscopic features of erythema nodosum?
»How is erythema nodosum treated?
»What is nodular vasculitis?
»What causes nodular vasculitis?
»Describe the microscopic features of nodular vasculitis.
»What is the differential diagnosis of nodular vasculitis?
»How should nodular vasculitis be treated?
»What are the clinical features of lupus panniculitis?
»Describe the microscopic features of lupus panniculitis.
»What is the significance of diagnosing lupus panniculitis?
»Are sclerema neonatorum and subcutaneous fat necrosis of the newborn the same thing?
»How similar are the microscopic features of sclerema neonatorum and subcutaneous fat necrosis of the newborn?
»Why do these disorders occur in neonates and infants?
»What is pancreatic fat necrosis?
»Are there any characteristic histopathologic features of pancreatic fat necrosis?
»What is the role of a-1 antitrypsin deficiency in the development of panniculitis?
»Name some types of trauma that can produce panniculitis.
»Which infectious organisms can produce panniculitis?
»Describe the role of malignancy in producing panniculitis.
»What is lipodystrophy?
»What is lipoatrophy?
»What is lipohypertrophy?
»Discuss the approach to use when attempting to diagnose an “unknown” case of panniculitis.

 
 
 

Name the various types of panniculitis. How are they classified?

 
Although no single classification seems to be totally satisfactory, disorders tend to be grouped by a combination of histopathologic features and etiologies (Table 19-1). Septal panniculitis refers to a predominance of inflammation involving the connective tissue septae between fat lobules, whereas lobular panniculitis indicates predominant involvement of the fat lobules themselves. Lipodystrophy and lipoatrophy may be end-stage changes of the fat brought about by several different etiologies, including inflammation, trauma, or metabolic or hormonal alterations.


Table 19-1. Major Forms of Panniculitis
 
Septal Panniculitis

Erythema nodosum
Subacute nodular migratory panniculitis
Scleroderma panniculitis

Lobular and Mixed Panniculitis

Nodular vasculitis (erythema induratum)
Lupus panniculitis
Other types of connective tissue panniculitis

Metabolic Derangements

Altered melting/solidification points of fat

Sclerema neonatorum
Subcutaneous fat necrosis of the newborn

Pancreatic (enzymatic) fat necrosis
Alpha-1 antitrypsin deficiency panniculitis
Traumatic Panniculitis

Infectious Panniculitis

Malignancy

Other Changes of the Fat

Lipodystrophy

Lipoatrophy

Lipohypertrophy