Fasciitis‐panniculitis in Acute Brucellosis

The fasciitis‐panniculitis syndromes: histomorphometric assessment of the inflammatory and sclerosing processes affecting the subcutaneous and fascial tissues

“…Skin-to-muscle biopsies of patients with an idiopathic or a secondary form of the fasciitis-panniculitis syndromes display chronic inflammatory infiltration of the subcutaneous septa, fascia and fat tissue, sclerosing thickening of the septa and fascia, and partial fibrous replacement of the adipose lobules. Elastosis and mucinosis of the newly formed fibrous tissue, vasculitis, phlebosclerosis and giant cell granulomas constitute additional findings, which, however, are not a prerequisite for the diagnosis of the fasciitispanniculitis syndrome (4, 5,[9][10][11][12][13][14][15]. The results of our histomorphometric analyses of the subcutaneous layers of the patients with either idiopathic or secondary forms of the fasciitis-panniculitis syndromes indicate a linear phenotypic expression:…”

“…For instance, the subcutaneous fat tissue of a patient with acute brucellosis was intensely inflamed while the fascia was but mildly inflamed. However, in a patient with low-grade fasciitis-panniculitis syndrome (median extent of fibrosis 10% and median cell count 29), the thickened fascia, rather than the subcutis, contained most of the inflammatory cells (4, 13,17). Falanga maintains that the inflammatory-sclerosing process originates in the fascia, spreading upwards to the panniculus adiposus and downwards to the perimysium (18).…”

Munchausen's syndrome presenting as severe panniculitis

“…Thus, after histological confirmation of acute panniculitis, our patient underwent a complete checkout for a variety of local or systematic causes associated with fat necrosis. We excluded trauma, cold, drugs and lipodystrophy (13), and we performed tests for autoimmune, collagen and vascular diseases, such as systemic lupus erythematosus and scleroderma (14,15), lymphoproliferative disorders, a1 anti‐thrypsin deficiency, pancreatic disease, bacterial or virus infections (16,17) and protein and complement abnormalities (13). Cesarean section is not considered to be a pre‐disposing factor for fat necrosis (18).…”

Skin Infections

“…In adults, the lesion is more common on the hands due to contact with infected animals such as rabbits, goats, and sheep. 99,100 This gram-negative coccobacillus is usually found in milk or animal products. In children, the head and neck are the common sites, where they have been bitten by insects carrying the organism.…”