Panniculitis is inflammation of the fatty layer under the skin, causing painful skin masses and non-specific symptoms. Causes include systemic and localized diseases, and treatment depends on the identified cause. Diagnosis requires a deep skin biopsy of the tender mass.
Panniculitis is a general term for inflammation of the fatty layer, the panniculus adipose, under the skin. An affected person would go to the doctor due to painful skin masses and non-specific symptoms, such as fatigue and weight loss. Treatment of this condition depends on the identified cause.
The panniculus adiposus is located on the outside of the panniculus carnosus, a thin layer of muscle. Various ailments can cause an inflamed panniculus fat, but have similar panniculitis symptoms. An affected person usually feels that their skin is thick and wood-like. This sensation is often accompanied by a reddish or dark coloration, along with tenderness.
A deep skin biopsy of the tender mass is required for its diagnosis. Once panniculitis is confirmed, doctors try to identify the cause. Additional symptoms such as fever, pain, arthritis, and pre-existing conditions all provide a clue as to the cause.
Causes of panniculitis include systemic disease and localized disease. Localized diseases are usually limited in location and do not involve other areas of the body. Lipodermatosclerosis is one of the localized soft tissue diseases whose main feature is inflammation of the panniculus. Only the lower extremities are affected by this condition, and patients have painful legs that look like upside-down soda bottles and may have a reddish-brown color. Most often, this condition is secondary to venous insufficiency and/or obesity.
Systemic diseases are disorders involving the whole body. These disorders include systemic lupus erythematosus and scleroderma. Lymphomas and pancreatic cancer can also cause inflammation of the subcutaneous fat.
Erythema nodosum is a common form of panniculitis in which the body’s reaction to immune challenges such as infections, medications, pregnancy, and cancer, leads to skin manifestations. Infections that can cause erythema nodosum include strep throat, tuberculosis, and leprosy, and medications that can cause erythema nodosum include sulfonamides, such as co-trimoxazole, and oral contraceptive pills. Erythema nodosum first appears on the front leg or shins as red, tender nodules with irregular edges during the first week. In the second week, these nodules take on a bluish color, followed by a yellowish hue. When the overlying skin peels or disappears within a week or two, the nodules eventually disappear.
Once the doctor has identified the cause of panniculitis, appropriate treatment is started. For example, some cases of erythema nodosum may require stopping a specific drug or being given a specific antibiotic. In the case of connective tissue disorders, such as lupus erythematosus, steroids may be given to suppress the immune system. In other cases, an anti-inflammatory and analgesic treatment, such as ibuprofen, celecoxib and diclofenac, may be justified.
Protect your devices with Threat Protection by NordVPN
