Panniculitis and lipodystrophy

Abstract

Panniculitis and lipodystrophy are rare disorders of subcutaneous tissue. Recently the incidence of lipodystrophy has been increasing secondary to its appearance in patients with HIV. In this population, the lipodystrophy appears to be a direct consequence of drug therapy. A review of the available literature regarding pathogenesis and treatment options is discussed. The diagnosis of panniculitis has been hampered by problems. The recent literature has concentrated on ways of improving pathologic diagnostic yields, and new aids in diagnosis are presented.

Childhood acquired lipodystrophy: A retrospective study

“…Although uncommon in childhood, acquired LD may have its onset during childhood or adolescence. In children, acquired LD is strongly associated with panniculitis, 1 juvenile dermatomyositis (JDM), 2 and systemic lupus erythematosus. 3 Very localized forms of the disease have been noted after local trauma, particularly subcutaneous injections of various medications.…”

Subcutaneous inflammation (panniculitis) in tibio-tarsal joint of rats inoculated with complete Freund’s adjuvant

“…These findings resembled the classic panniculitis associated with tuberculosis (TB), which is known as erythema induratum (EI) [7]. EI is characterised by either focal or diffuse, lobular or septolobular granulomatous panniculitis in association with neutrophilic vasculitis of either large or small blood vessels.…”

Panniculitis in childhood and adolescence

“…These are characterized by inflammation of the fatty tissue, leading to the emergence of painful subcutaneous nodules, predominantly located in the lower limbs. Histology reveals septal and/or lobular panniculitis 1,3,6 …”

“…The disease is chronic, with periods of activity and remission, and the mortality is between 10 and 15% 2 . Laboratory testing may reveal elevation of the erythrocyte sedimentation rate, anemia, leukopenia or leukocytosis 3 . Suggested treatment consists of corticosteroids and/or immunosuppressive drugs 1 …”

“…2 Laboratory testing may reveal elevation of the erythrocyte sedimentation rate, anemia, leukopenia or leukocytosis. 3 Suggested treatment consists of corticosteroids and/or immunosuppressive drugs. 1 The objective of the present study was to describe the cases of panniculitis diagnosed at the Pediatric Rheumatology Unit, University of São Paulo (HC-FMUSP), from January 1983 to December 2002.…”