Encapsulated fat necrosis: a form of traumatic panniculitis

Santos‐Juanes, Jorge; Coto, Pablo; Galache, Cristina; Río, José Sánchez del; Delas, J. Soto De

doi:10.1111/j.1468-3083.2006.01889.x

Cited by 16 publications

(18 citation statements)

References 8 publications

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“…As illustrated in our case, fat necrosis is often encapsulated, which is thought to help prevent extension and spread of the inflammatory lesion into surrounding tissues (5). Fat necrosis can present at any age and usually occurs on lower extremities and breast tissue (often following an unnoticed injury) (6). One of the problems of literature searches on fat necrosis is that terminology is varied, including ‘nodular-cystic fat necrosis’, ‘mobile encapsulated lipoma’, ‘nodular fat necrosis’ and ‘post-traumatic fat degeneration’ (7).…”

Section: Discussionmentioning

confidence: 73%

Painful fat necrosis resulting from insulin injections

Hanson

Pandit

Menon

et al. 2014

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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SummaryThe case is a 34-year-old woman with long-standing type 1 diabetes mellitus with existing follow-up in the outpatient clinic at the Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, UHCW. She had maintained good glycaemic control and glycaemic stability with basal bolus regimen for many years. She had not developed any diabetes-related complications and had no other co-morbidities. Six months ago, she presented to A&E with sudden-onset, well-localised and severe pain in the right iliac fossa, just lateral to the para-umbilical area. Her biochemistry was normal. Ultrasound scan, however, revealed a right-sided ovarian cyst, which was thought to have caused pain to her. She was discharged from A&E with simple analgesia. On subsequent gynaecological follow-up 4 weeks later, her pain remained severe and examination revealed an exquisitely tender subcutaneous nodule at the same location measuring 2 cm in diameter. Magnetic resonance imaging (MRI) scan at the time revealed a 1 cm mass in the subcutaneous adipose tissue, which co-localised to her pain. The mass demonstrated a central fat signal surrounded by a peripheral ring: observations consistent with fat necrosis. There were other smaller subcutaneous nodules also observed in the left para-umbilical area. Subsequent surgical resection of the main area of fat necrosis was performed. The patient made an excellent recovery and her pain resolved post-operatively. Histology confirmed the presence of fat necrosis. Fat necrosis is a rare complication of s.c. insulin injection. This case illustrates the importance of considering this diagnosis in patients who inject insulin and develop localised injection-site pain.Learning points Fat necrosis is a rare complication of insulin injections that can manifest with severe, persistent and well-localised pain.Fat necrosis can masquerade as other pathologies causing diagnostic confusion.The imaging modality of choice for accurate diagnosis of fat necrosis is MRI.Histological confirmation of fat necrosis is important.Appropriate management of localised fat necrosis is surgical excision, with avoidance of further insulin injections into the affected area.

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Section: Discussionmentioning

confidence: 73%

Painful fat necrosis resulting from insulin injections

Hanson

Pandit

Menon

et al. 2014

Endocrinology, Diabetes &Amp; Metabolism Case Reports

View full text Add to dashboard Cite

show abstract

“…Multiple cutaneous side effects are associated with repeated insulin injections, including localized infection, lipodystrophy, allergic reactions, idiosyncratic reactions (e.g. amyloidosis and hyperpigmentation 1 ), and fat necrosis 2–5 …”

Section: Discussionmentioning

confidence: 99%

“…Fat necrosis arising after insulin injections usually appears as firm, encapsulated, mobile, non‐tender, solitary or multiple subcutaneous nodules. These nodules arise occasionally after a traumatic episode 3 and are usually located on the inferior limbs 3–5 . In addition, they have a tendency to recur after surgical excision 4 .…”

Section: Discussionmentioning

confidence: 99%

“…In addition, they have a tendency to recur after surgical excision 4 . Histology of the nodules shows fat cell necrosis surrounded by a fine or thick capsule, with possible calcifications, lipomembranous changes, and inflammatory infiltrates 3–5 . Fat necrosis can also be associated with traumatic panniculitis secondary to ischemic disorders 3,4 .…”

Section: Discussionmentioning

confidence: 99%

“…Fat necrosis can also be associated with traumatic panniculitis secondary to ischemic disorders 3,4 . Several synonyms for this condition exist in the literature, including nodular‐cystic fat necrosis, mobile encapsulated lipoma, nodular fat necrosis, post‐traumatic fat degeneration, and herniation 3 …”

Section: Discussionmentioning

confidence: 99%

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