High-frequency ultrasound features in a case of gouty panniculitis

Cid, Paola Maldonado; Flores, Cristina Rubio; Caelles, Iolanda Prats; Dosil, V. M. Leis; Roldan, Fernándo Alfageme; Alberti, Piero; Garriga, César; Diaz, Raiko

doi:10.5070/d3236035386

Cited by 6 publications

(3 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These features were associated with a lobular-type panniculitis on histology. 4 In our case series, the core findings of septal panniculitis were confirmed to be hypoechoic, not compressible septa, in the context of a hyperechoic, lobular hypodermis. Furthermore, decreased prominence/blurriness of septal appearance may be indicative of lobular involvement, albeit minor.…”

supporting

confidence: 59%

Ultrasonographic diagnosis of erythema nodosum

Nazzaro

Maronese

Passoni

2021

Skin Research and Technology

View full text Add to dashboard Cite

To the Editor, Erythema nodosum (EN) is an acute, septal panniculitis, presumably resulting from massive deposition of immune complexes in the venules of subcutaneous fat. 1 It represents a stereotypical reaction pattern to a wide variety of triggering factors -such as infections, autoimmune diseases, drugs, and classically manifests with painful, rounded to oval, slightly raised, non-ulcerative erythematous nodules on the extensor aspect of the lower limbs. 1

show abstract

supporting

confidence: 59%

Ultrasonographic diagnosis of erythema nodosum

Nazzaro

Maronese

Passoni

2021

Skin Research and Technology

View full text Add to dashboard Cite

show abstract

“…This is the reason why implementation of noninvasive techniques such as dermatologic US examinations is desirable. Dermatologic US can provide information about the predominantly septal or lobular nature of the panniculitis and additionally about the presence of additional signs such as fat necrosis, calcium deposition, and venous dilalation . It is a noninvasive test that can even be repeated during the clinical course of the lesions, adding dynamic information about their evolution.…”

mentioning

confidence: 99%

“…Dermatologic US can provide information about the predominantly septal or lobular nature of the panniculitis and additionally about the presence of additional signs such as fat necrosis, calcium deposition, and venous dilalation. [4][5][6] It is a noninvasive test that can even be repeated during the clinical course of the lesions, adding dynamic information about their evolution. In our setting, the most frequently diagnosed form of panniculitis is erythema nodosum, followed by sclerosing panniculitis and nodular vasculitis/ erythema induratum of Bazin.…”

mentioning

confidence: 99%

Inter‐ and Intra‐rater Agreement of Dermatologic Ultrasound for the Diagnosis of Lobular and Septal Panniculitis

Romaní

Giavedoni

Roé

et al. 2019

J of Ultrasound Medicine

View full text Add to dashboard Cite

Objectives-Dermatologic ultrasound (US) may aid in the diagnosis and classification of panniculitis. The purpose of this study was to assess the capability of dermatologic US for subtyping mainly septal/lobular panniculitis.Methods-A multicentric and prospective study of the inter-and intra-rater agreement of dermatologic US for subtyping panniculitis was conducted among 4 clinicians with experience in dermatologic US and a radiologist specialized in dermatologic US. Clinicians recruited patients and performed dermatologic US examinations of the most substantial lesion and punch biopsies. A histologic study was considered the reference standard. Then the images were blindly evaluated by all researchers. For intra-and inter-rater agreement, Cohen and Fleiss κ values were calculated.Results-Sixty-four patients were included. The Cohen intra-rater κ was 0.74. Sensitivity and specificity for lobular panniculitis were 85.19 and 88.57, respectively. The Fleiss inter-rater κ was 0.47. Limitations of the study included the small number of patients and differences in evaluators and their dermatologic US equipment.Conclusions-This study supports the use of US for diagnosing panniculitis. For subtyping panniculitis, the intra-rater correlation was good. Improvement of inter-rater agreement may depend on access to clinical information, dynamic images, a better definition of criteria, homogeneous configurations of the devices, and the expertise of dermatologic US operators.

show abstract

Panniculitis

Requena,

Cerroni

2024

Rook's Textbook of Dermatology

View full text Add to dashboard Cite

The panniculitides represent a group of heterogeneous inflammatory diseases that involve the subcutaneous fat. The specific diagnosis of these disorders requires histopathological study because different panniculitides usually show monotonous clinical appearance, namely subcutaneous erythematous nodules on the lower extremities. Histopathological study of panniculitis is also challenging because of an inadequate clinicopathological correlation and the evolutionary nature of the lesions. Often, biopsy specimens are taken from late‐stage lesions, which results in non‐specific histopathological findings. In addition, large‐scalpel incisional biopsies are required. However, with adequate biopsy samples a histopathological differential diagnosis between a mostly septal and a mostly lobular panniculitis is straightforward and with adequate clinicopathological correlation, a specific diagnosis may be rendered in most cases of panniculitis. Mostly septal panniculitides with vasculitis include superficial thrombophlebitis and cutaneous polyarteritis nodosa (cutaneous arteritis). Septal panniculitides with no vasculitis may appear as the consequence of dermal inflammatory processes extending to the subcutaneous fat, such as necrobiosis lipoidica, scleroderma, subcutaneous granuloma annulare, rheumatoid nodule and necrobiotic xanthogranuloma, whereas in other cases the inflammatory process involves primarily the connective tissue septa of the subcutis with no participation of the overlying dermis. The most frequent septal panniculitis is erythema nodosum. In contrast, the most common lobular panniculitis with vasculitis is erythema induratum of Bazin (nodular vasculitis). Mostly lobular panniculitides without vasculitis comprise a large list of disorders, including sclerosing panniculitis (lipodermatosclerosis), subcutaneous fat necrosis of the newborn, panniculitis associated with connective tissue diseases, pancreatic panniculitis, 1 ‐antitrypsin deficiency‐associated panniculitis, infective panniculitis and factitious panniculitis. In recent years, several cases of both septal and lobular panniculitis have been described as a consequence of the administration of new drugs, including immune checkpoint inhibitors and BRAF inhibitors used as treatment of metastatic melanoma, tyrosine kinase and Bruton tyrosine kinase inhibitors used for treatment of leukemia and other haematological malignancies and tumour necrosis factor inhibitor drugs.

show abstract

High-frequency ultrasound features in a case of gouty panniculitis

Cited by 6 publications

References 8 publications

Ultrasonographic diagnosis of erythema nodosum

Ultrasonographic diagnosis of erythema nodosum

Inter‐ and Intra‐rater Agreement of Dermatologic Ultrasound for the Diagnosis of Lobular and Septal Panniculitis

Panniculitis

Contact Info

Product

Resources

About