1
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Yokoi S, Iwata Y, Sugiura K. A retrospective clinicopathological study of erythema nodosum. J Dermatol 2024. [PMID: 38507514 DOI: 10.1111/1346-8138.17195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/29/2024] [Accepted: 02/26/2024] [Indexed: 03/22/2024]
Abstract
Erythema nodosum (EN) may be idiopathic or secondary, and usually resolves naturally within 1-2 months. In atypical EN cases, the rash extends beyond the lower limbs to the upper limbs and trunk, and histopathological findings may be accompanied by vasculitis in addition to septal panniculitis. Few studies have examined the differences in the clinical characteristics of patients with EN based on rash distribution. We retrospectively examined whether there was a correlation with clinical information, such as the presence or absence of underlying diseases, by classifying the patients into two groups: the lower limbs group (the EN rash was confined to the lower limbs) and the beyond lower limbs group (the EN rash appeared beyond the lower limbs). Among the 86 adult patients diagnosed with EN at the Dermatology Department of Fujita Medical University between 2015 and 2020, there were 65 cases of the lower limbs group and 21 cases of the beyond lower limbs group. The frequency of underlying diseases was significantly higher in the beyond lower limbs group (76.2%, 16 cases) than in the lower limbs group (40.0%, 26 cases; P < 0.005). Vasculitis was more notable in the beyond lower limbs group (P < 0.05). Significantly higher vasculitis was noted in the EN group with underlying diseases (30.2%, 13 cases) than in the idiopathic EN group without underlying diseases (11.6%, 5 cases; P < 0.05). Neutrophil extracellular traps were positive in approximately 40% of cases in both groups. In the beyond lower limbs group, the possibility of severe cases with underlying diseases, vasculitis, and inflammation must be considered for effective treatment.
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Affiliation(s)
- Satomi Yokoi
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Yohei Iwata
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Kazumitsu Sugiura
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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2
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Kumar R, Cichelli K, Brent L. Pancreatitis, Panniculitis, and Polyarthritis Syndrome as the First Symptom of Necrotizing Pancreatitis. Cureus 2024; 16:e55362. [PMID: 38562324 PMCID: PMC10982830 DOI: 10.7759/cureus.55362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome is a very rare cutaneous manifestation found in patients with acute pancreatitis. We report the case of a 44-year-old man presenting with erythematous, painful lesions on the lower extremities and ankle swelling. The rheumatology service was consulted for possible erythema nodosum. Extensive workup revealed elevated lipase and amylase levels, and computed tomography of the abdomen and pelvis revealed acute pancreatitis with necrotizing lesions and peripancreatic thoracic collections. There were also changes of chronic pancreatitis. The original skin manifestations were eventually identified as pancreatic panniculitis by skin biopsy. The patient was treated for pancreatitis and pleural effusions, and his skin and joint symptoms completely resolved. Pancreatic panniculitis with polyarthritis is rare but may be the first presenting symptom of pancreatic disease. Rheumatology may be consulted for these patients especially if there are only skin and joint manifestations and no abdominal pain. Misdiagnosis of pancreatitis can lead to poorer outcomes and delay in care. Therefore, pancreatic disease should be on the differential for any patient with panniculitis and polyarthritis.
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Affiliation(s)
- Raagni Kumar
- Internal Medicine, Temple University Hospital, Philadelphia, USA
| | | | - Lawrence Brent
- Rheumatology, Temple University Hospital, Philadelphia, USA
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3
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Kolagatla S, Gullapalli D, Vangara A, Chan R, Jernigan D, Moka N, Ganti SS. Characteristics of Patients With Alpha-1 Antitrypsin Deficiency From Rural Appalachia: A Retrospective Single-Center Study. Cureus 2024; 16:e56395. [PMID: 38633947 PMCID: PMC11023687 DOI: 10.7759/cureus.56395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Alpha-1 antitrypsin (AAT) deficiency, an autosomal co-dominant inherited condition, significantly impacts lung and liver functions, with mutations in the SERPINA1 gene, notably the Z allele, playing a pivotal role in disease susceptibility. This retrospective descriptive study from a rural Eastern Kentucky pulmonary clinic aimed to characterize patients with AAT deficiency, focusing on demographic, clinical, and laboratory parameters extracted from electronic health records (EHR) of Appalachian Regional Healthcare (ARH). Among 100 patient encounters, 56 were analyzed, revealing notable sex-based differences in smoking rates and co-existing conditions, with males showing higher rates of black lung and chronic obstructive pulmonary disease. In comparison, females exhibited higher rates of asthma, COVID-19, pneumothorax, and obstructive sleep apnea. The study emphasizes the importance of understanding genotype-phenotype correlations and demographic factors in assessing AAT deficiency, advocating for further research to refine management strategies and elucidate causal relationships.
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Affiliation(s)
| | | | - Avinash Vangara
- Internal Medicine, Appalachian Regional Healthcare, Harlan, USA
| | - Regina Chan
- Physical Medicine and Rehabilitation, Albany Medical College, Albany, USA
| | - Derek Jernigan
- Internal Medicine, Kettering Medical Center, Kettering, USA
| | - Nagabhishek Moka
- Oncology, Hematology, and Internal Medicine, Appalachian Regional Healthcare, Hazard, USA
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4
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Farrugia S, Cachia M, Betts A, Clark E. Nodular vasculitis (erythema induratum) associated with systemic minocycline. Australas J Dermatol 2024; 65:167-170. [PMID: 38057959 DOI: 10.1111/ajd.14195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/29/2023] [Accepted: 11/21/2023] [Indexed: 12/08/2023]
Abstract
A 29-year-old Caucasian woman presented with a 3-month history of bilateral lower limb swelling with painful erythematous nodules on shins without ulceration. She had been taking minocycline for acne vulgaris for 3 years. Biochemical investigations showed deranged liver function test with positive ANA and mixed antinuclear factor (ANF) pattern. A skin biopsy was in keeping with a diagnosis of nodular vasculitis. Her skin lesions and liver function test improved within 3 months of stopping the minocycline treatment. This case report raises the awareness that minocycline could be a potential cause of nodular vasculitis, patients on minocycline should be closely monitored and minocycline should ideally not be prescribed for more than 12 weeks, given the possible adverse effects.
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Affiliation(s)
| | - Monique Cachia
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | | | - Eileen Clark
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
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5
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Fujisaki M, Kasamatsu H, Nishimura K, Yoshida Y, Muneishi Y, Yamaguchi T, Nishino I, Konishi R, Ichimura Y, Okiyama N, Oyama N, Hasegawa M. A case of anti-SAE1/2 antibody-positive dermatomyositis with extensive panniculitis: A possible cutaneous manifestation of treatment resistance. J Dermatol 2024; 51:301-306. [PMID: 37830399 DOI: 10.1111/1346-8138.17000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/29/2023] [Accepted: 09/28/2023] [Indexed: 10/14/2023]
Abstract
Dermatomyositis constitutes a heterogeneous group of autoimmune inflammatory conditions with a wide variety of clinical outcomes. The symptomatic heterogeneity carries skin, muscle, and joint manifestations; pulmonary and cardiac involvements; and concomitant malignancy. Any of these symptoms often appear at different combinations and time courses, thus posing difficulty in early diagnosis and appropriate treatment choice. Recent progress in laboratory investigations explored the identification of several myositis-specific autoantibodies (MSAs) and myositis-associated autoantibodies, allowing precise characterization for a clinical perspective of the disease. MSAs can be detectable in approximately 80% of patients with whole dermatomyositis, some of which closely reflect unique clinical features in the particular disease subset(s), including the distribution and severity of organ involvement, treatment response, and prognosis. However, only limited evidence has been available in dermatomyositis-associated panniculitis, mostly that in anti- melanoma differentiation-associated protein 5 antibody-positive disease. We present a rare case of a patients with dermatomyositis with extensive panniculitis on the trunk whose serum IgG autoantibodies reacted with both subunits of small ubiquitin-like modifier activating enzymes (SAEs), SAE1 and SAE2. The onset of panniculitis coincided with increased disease activity, including disease-related skin manifestations, fever, dysphagia, and muscle weakness in the extremities. These symptoms responded well to a high dose of systemic steroid, but even upon receiving a high-dose intravenous immunoglobulin, the panniculitic lesions and pruritic erythema flared with tapering of steroid dose, further requiring tacrolimus and mycophenolate mofetil to achieve disease remission. To our knowledge, this is the third reported case of anti-SAE autoantibody-positive dermatomyositis with panniculitis. We aim to extend the understanding of the current limitation and further perspective in the clinical management of the extremely rare skin manifestation associated with dermatomyositis.
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Affiliation(s)
- Misako Fujisaki
- Department of Dermatology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroshi Kasamatsu
- Department of Dermatology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kentarou Nishimura
- Department of Dermatology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yasuyuki Yoshida
- Department of Dermatology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yoriko Muneishi
- Department of Dermatology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tomohisa Yamaguchi
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Risa Konishi
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuki Ichimura
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Naoko Okiyama
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noritaka Oyama
- Department of Dermatology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Minoru Hasegawa
- Department of Dermatology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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6
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Sloan B. This Month in JAAD Case Reports: February 2024 Chagas disease reactivation presenting with vasculitis. J Am Acad Dermatol 2024; 90:253. [PMID: 38036099 DOI: 10.1016/j.jaad.2023.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 12/02/2023]
Affiliation(s)
- Brett Sloan
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut.
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Al Shaltouni DZ, Abou Hussein B, Sawan BA, Saleh LO, Alozaibi LS. Idiopathic Isolated Mesenteric Panniculitis: A Case Report of a Rare Adipose Tissue Disease. Cureus 2024; 16:e53776. [PMID: 38465096 PMCID: PMC10923501 DOI: 10.7759/cureus.53776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 03/12/2024] Open
Abstract
Mesenteric panniculitis belongs to a spectrum of rare diseases affecting the fatty tissue of the mesentery. It is characterized by chronic inflammation and fibrosis of the mesenteric adipose tissue of the bowel. Patients typically present with symptoms such as abdominal pain, nausea, vomiting, anorexia, bloating, and weight loss. Computed tomography (CT) is commonly used for diagnosis in most cases. We present a case of a 42-year-old male who experienced a significant escalation of abdominal pain over a 24-hour period. Despite seeking medical care at multiple hospitals and being prescribed analgesics, his pain remained unrelieved. Based on CT findings and the worsening pain, mesenteric panniculitis was suspected, leading to a diagnostic laparoscopy that confirmed the diagnosis. The patient was treated for idiopathic isolated mesenteric panniculitis during his hospital stay and was subsequently discharged. This article emphasizes the importance of considering mesenteric panniculitis as a possible differential diagnosis in patients with nonspecific abdominal pain, to avoid overlooking this condition.
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Affiliation(s)
| | | | - Batool A Sawan
- General Surgery, Rashid Hospital / Dubai Medical College, Dubai, ARE
| | - Leen O Saleh
- General Surgery, Rashid Hospital / Dubai Medical College, Dubai, ARE
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8
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Kye Y, Zhao G, Guhan S, Nunes D, Nguyen CV. Research letter: BRAF-inhibitor induced panniculitis - A systematic review. J Am Acad Dermatol 2024; 90:420-423. [PMID: 37943239 DOI: 10.1016/j.jaad.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/30/2023] [Accepted: 10/05/2023] [Indexed: 11/10/2023]
Affiliation(s)
- Yae Kye
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Paul L Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas
| | - Grant Zhao
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Samantha Guhan
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Denise Nunes
- Galter Health Science Library, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Cuong V Nguyen
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
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9
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Martins F, Martins M, Malheiro R. Löfgren Syndrome: A Mosaic of Sarcoidosis Phenotypes. Cureus 2024; 16:e52317. [PMID: 38226315 PMCID: PMC10789483 DOI: 10.7759/cureus.52317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 01/17/2024] Open
Abstract
Sarcoidosis is an autoimmune multisystemic granulomatous disease with an unknown etiology. Löfgren syndrome (LS), an infrequent initial presentation of acute sarcoidosis, is characterized by the classic triad of acute arthritis, erythema nodosum (EN), and bilateral hilar lymphadenopathy (BHL). The presence of this triad offers high diagnostic specificity for sarcoidosis, eliminating the need for a confirmatory biopsy. Typically, LS follows a predictable, self-limiting clinical course. However, atypical presentations require early suspicion and closer monitoring. This case report highlights an unusual clinical manifestation of LS, marked by an incomplete presentation with acute panniculitis and joint lesions in the absence of EN. Acute sarcoidosis should be considered among the differential diagnoses when these clinical manifestations are present, and chest radiography should be performed to rule out BHL. In atypical cases, the disease course becomes less predictable, as exemplified in our case, where recurrence of the disease may occur, necessitating consistent monitoring.
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Affiliation(s)
- Francisca Martins
- Internal Medicine, Centro Hospitalar Universitário de Lisboa Central, Lisbon, PRT
| | - Miguel Martins
- Internal Medicine, Centro Hospitalar Universitário de Lisboa Central, Lisbon, PRT
| | - Rui Malheiro
- Internal Medicine, Centro Hospitalar Universitário de Lisboa Central, Lisbon, PRT
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10
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Biro M, Hill AL, Cardis M, Pasieka HB, Farhat FZ. Chagas disease reactivation associated with cutaneous vasculitis in a heart transplant patient. JAAD Case Rep 2023; 42:42-44. [PMID: 38034365 PMCID: PMC10681877 DOI: 10.1016/j.jdcr.2023.09.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Affiliation(s)
- Mark Biro
- Department of Dermatology, MedStar Washington Hospital Center, Washington, District of Columbia
| | - Alison L. Hill
- Department of Dermatology, Georgetown University School of Medicine, Washington, District of Columbia
| | - Michael Cardis
- Department of Dermatology, MedStar Washington Hospital Center, Washington, District of Columbia
| | - Helena B. Pasieka
- Department of Dermatology, MedStar Washington Hospital Center, Washington, District of Columbia
- Department of Dermatology, Georgetown University School of Medicine, Washington, District of Columbia
- Departments of Dermatology & Medicine, Uniformed Services University, Bethesda, Maryland
| | - Freba Z. Farhat
- Department of Dermatology, MedStar Washington Hospital Center, Washington, District of Columbia
- Department of Dermatology, Georgetown University School of Medicine, Washington, District of Columbia
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11
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Faccin M, Wiener DJ, Rech RR, Santoro D, Rodrigues Hoffmann A. Common superficial and deep cutaneous bacterial infections in domestic animals: A review. Vet Pathol 2023; 60:796-811. [PMID: 37264789 DOI: 10.1177/03009858231176558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The skin covers the external surface of animals, and it is constantly exposed to and inhabited by different microorganisms, including bacteria. Alterations in the skin barrier allow commensal and/or pathogenic bacteria to proliferate and penetrate deep into the lower layers of the skin. Being the first barrier to the external environment, the skin is prone to injuries, allowing the penetration of microorganisms that may lead to severe deep infections. Companion animals, especially dogs, are prone to bacterial infections, often secondary to allergic dermatitis. When environmental conditions are unfavorable, horses, cattle, sheep, and goats can develop superficial infections, such as those caused by Dermatophilus congolensis. Deep inflammation is commonly caused by Mycobacterium spp., which results in granulomatous to pyogranulomatous dermatitis and panniculitis. Likewise, bacteria such as Nocardia spp. and Actinomyces spp. can cause deep pyogranulomatous inflammation. Bacteria that lead to deep necrotizing lesions (eg, necrotizing fasciitis/flesh-eating bacteria) can be severe and even result in death. This review includes an overview of the most common cutaneous bacterial infections of domestic animals, highlighting the main features and histologic morphology of the bacteria, cutaneous structures involved, and the type of inflammatory infiltrates.
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12
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Borges T, Silva S. Panniculitis: A Cardinal Sign of Autoinflammation. Curr Rheumatol Rev 2023:CRR-EPUB-135664. [PMID: 37921131 DOI: 10.2174/0115733971254702231020060633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 08/19/2023] [Accepted: 09/01/2023] [Indexed: 11/04/2023]
Abstract
Panniculitis was first described in the nineteenth century and is characterized by inflammation of the subcutaneous fat. It may be categorized in septal or lobular subtypes, but other histopathological features (e.g., presence of vasculitis, nature of inflammatory infiltrates, characteristics of fat necrosis) are also important for diagnostic purposes. Clinically, panniculitis is characterized by the presence of subcutaneous nodules, and both ulcerative and nonulcerative clinical subtypes have been proposed. In this review, we aimed to describe the occurrence of panniculitis in autoinflammatory disorders (AIDs) and related diseases. Among monogenic AIDs, panniculitis is common in IFN-mediated disorders. Panniculitis is a distinctive feature in proteasome-associated autoinflammatory syndromes (PRAAS), including chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE) syndrome and Nakajo-Nishimura syndrome. On the other hand, erythema nodosum corresponds to the most common clinical form of panniculitis and is common in polygenic AIDs, such as Behçet's syndrome, inflammatory bowel disease, and sarcoidosis. Cytophagic histiocytic panniculitis, lipoatrophic panniculitis of children, and otulipenia are rare disorders that may also present with inflammation of the subcutaneous fat. Therefore, panniculitis can identify a specific subgroup of patients with AIDs and may potentially be regarded as a cardinal sign of autoinflammation.
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Affiliation(s)
- Tiago Borges
- Trofa Saúde Gaia, Rua Fernão de Magalhães nº 2 Fr E, 4404-501 Vila Nova de Gaia, Portugal
| | - Sérgio Silva
- Trofa Saúde Gaia, Rua Fernão de Magalhães nº 2 Fr E, 4404-501 Vila Nova de Gaia, Portugal
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13
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Li D, Chen J, Chen M, Tang Y, Su J. A case of progressive crossed hemiatrophy mistaken as panniculitis. J Dermatol 2023; 50:1203-1207. [PMID: 37248853 DOI: 10.1111/1346-8138.16814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/16/2023] [Accepted: 04/12/2023] [Indexed: 05/31/2023]
Abstract
Progressive crossed hemiatrophy is an extremely rare clinical type of facial hemiatrophy that presents primarily as unilateral facial atrophy and contralateral trunk or limb involvement. The undistinguishable clinical manifestation and pathological changes complicate diagnosis, especially at the onset of the disease when presenting with less clinical evidence. Here, we report a case of a 9-year-old boy started with left scalp induration, following with subcutaneous tissues atrophy on the right trunk. He was mistaken as panniculitis based on the pathologic findings and treated with topical tacrolimus without any improvement. Immune-related tests were implemented to exclude connective tissues. Imaging examinations such as magnetic resonance was conducted to evaluate the range and degree of the involvement of the skin, soft tissue, and cranial changes. Although no effective treatment to hold back the progress has been reported so far, surgeries might work to restore the appearance to some extent or improve central nerves symptoms if they exist.
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Affiliation(s)
- Daishi Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Junchen Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Mingliang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Yan Tang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Juan Su
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
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14
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Shajil C, Sathishkumar D, Babu JS, Babu R, Kumar S. Spontaneous crateriform indentation in a child. Pediatr Dermatol 2023; 40:715-717. [PMID: 37440194 DOI: 10.1111/pde.15241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 12/19/2022] [Indexed: 07/14/2023]
Affiliation(s)
- Chandana Shajil
- Departments of Dermatology, Christian Medical College and Hospital, Vellore, India
| | | | - Jyoti Sureka Babu
- Departments of Radiology, Christian Medical College and Hospital, Vellore, India
| | - Ramesh Babu
- Departments of Pathology, Christian Medical College and Hospital, Vellore, India
| | - Sathish Kumar
- Pediatric Rheumatology Unit, Department of Pediatrics, Christian Medical College and Hospital, Vellore, India
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15
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Gil-Lianes J, Gariup G, Iranzo-Fernández P, Mensa-Vilaró A, Peñín-Franch A, Hurtado-Navarro L, Pelegrin P, Aróstegui JI. Early-onset recurrent panniculitis as a phenotype of NLRC4-associated autoinflammatory syndrome: Characterization of pathogenicity of the p.Ser445Pro NLRC4 variant. Australas J Dermatol 2023; 64:260-267. [PMID: 36797819 DOI: 10.1111/ajd.14005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/21/2023] [Accepted: 01/27/2023] [Indexed: 02/18/2023]
Abstract
Monoallelic NLRC4 gain-of-function variants cause an inflammasomopathy with diverse clinical forms including infantile enterocolitis, recurrent macrophage activation syndrome, cold-induced urticaria-like lesions (or familial-cold autoinflammatory syndrome, FCAS4), and painful subcutaneous nodules. Here, we identified a large family with six consecutive generations affected. Genetic analyses detected the heterozygous p.Ser445Pro NLRC4 variant in three patients, which has been previously reported in a Dutch family with FCAS4. We aimed to describe the clinicopathological features and the functional consequences of the detected NLRC4 variant. Patients presented an early-onset (3 months-6 years) inflammatory disease characterized by recurrent panniculitis, fever and arthralgia. Histopathological examination showed perivascular and interstitial lymphohistiocytic infiltrates in the dermis and mixed panniculitis. Functional analysis supported the conclusion that the p.Ser445Pro NLRC4 variant leads to a constitutive activation of NLRC4-inflammasome and increased plasma levels of IL-18. Prompt recognition of early-onset panniculitis through clinicopathological examination and laboratory biomarkers may allow targeted therapies.
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Affiliation(s)
| | - Giuseppe Gariup
- Department of Dermatology, Hospital Clínic, Barcelona, Spain
| | | | - Anna Mensa-Vilaró
- Department of Immunology, Hospital Clínic, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Alejandro Peñín-Franch
- Molecular Inflammation Group, Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
| | - Laura Hurtado-Navarro
- Molecular Inflammation Group, Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
| | - Pablo Pelegrin
- Molecular Inflammation Group, Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
- Department of Biochemistry and Molecular Biology B and Immunology, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - Juan I Aróstegui
- Department of Immunology, Hospital Clínic, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- School of Medicine, University of Barcelona, Barcelona, Spain
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16
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Gleue C, Bois M, Guo R. Calciphylaxis in autopsy: A retrospective case-controlled study of 7 decedents. JAAD Case Rep 2023; 35:60-62. [PMID: 37078015 PMCID: PMC10106467 DOI: 10.1016/j.jdcr.2023.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Affiliation(s)
- Casey Gleue
- Division of Anatomic and Clinical Pathology, Mayo Clinic, Rochester, Minnesota
| | - Melanie Bois
- Division of Anatomic and Clinical Pathology, Mayo Clinic, Rochester, Minnesota
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Ruifeng Guo
- Division of Anatomic and Clinical Pathology, Mayo Clinic, Rochester, Minnesota
- Correspondence to: Ruifeng Guo, MD, PhD, Hilton Building, Mayo Clinic Department of Anatomic and Clinical Pathology, 210 2nd St SW, Rochester, MN 55905.
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17
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Piroth M, Goronflot T, Samaran R, Varey E, Poinas A, Khammari A, Dreno B. Panniculitis does not predict clinical response in patients with advanced melanoma under targeted therapy. Eur J Dermatol 2023; 33:126-136. [PMID: 37431115 DOI: 10.1684/ejd.2023.4467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
BACKGROUND BRAF and MEK inhibitors have changed the landscape of treatment for advanced melanoma. Among their side effects, panniculitis has been hypothesized to be associated with better survival. OBJECTIVES In this study, we aimed to explore the association between the occurrence of panniculitis during targeted therapy and outcome of metastatic melanoma. MATERIALS & METHODS This was a retrospective single-centre comparative study from 2014 to 2019. An English literature review was also conducted to further our understanding of the mechanism(s) involved and identify characteristics of this association, in order to support better management. RESULTS Ten patients who developed panniculitis during treatment were matched to 26 controls based on potential confounders at treatment introduction. The prevalence of panniculitis was 5.3%. Median progression-free survival (PFS) for all patients was 8.5 months (range: 3.0-94.0). The median PFS for the group with panniculitis was 10.5 months (7.0-undefined) and 7.0 months (6.0-32.0) for controls (p=0.39). According to the scientific literature, panniculitis occurring during targeted therapy affects mainly young people, predominantly women, with variable delay to onset (with half reported cases occurring in the first month). In addition, panniculitis usually only affects the lower limbs or is associated with other clinical signs (fever, arthralgia), without histological specificity. Discontinuation of targeted therapy is not required as spontaneous remission is usually experienced. Symptomatic treatment may be administered but systemic corticosteroids have not been proven to be effective. CONCLUSION In contrast to the belief that there is a link between panniculitis and clinical response to targeted therapy according to the literature, our results show that there is no significant association between the two.
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Affiliation(s)
- Marie Piroth
- Nantes Université, CHU Nantes Service de Dermatologie, Hôtel-Dieu, Nantes, Nantes, France
| | - Thomas Goronflot
- Nantes Université, CHU Nantes, Pôle Hospitalo-Universitaire 11: Santé Publique, Clinique des données, INSERM, CIC 1413, F-44000 Nantes, France
| | - Romain Samaran
- Service de Dermatologie, Hôpital du Mans, Le Mans, France
| | - Emilie Varey
- Nantes Université, CHU Nantes, Pôle Hospitalo-Universitaire 11: Santé Publique, Clinique des données, INSERM, CIC 1413, F-44000 Nantes, France
| | | | - Amir Khammari
- Nantes Université, CHU Nantes Service de Dermatologie, Hôtel-Dieu, Nantes, Nantes, France, Nantes Université, CHU Nantes, INSERM, CIC1413, Nantes, France, Nantes Université, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302. F-44000 Nantes, France
| | - Brigitte Dreno
- Nantes Université, CHU Nantes, INSERM, CIC1413, Nantes, France, Nantes Université, INSERM, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302. F-44000 Nantes, France
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18
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Singh H, Patel P, Parikh S, Zreik H, Caliman N, Kak V. Pancreatitis, panniculitis and polyarthralgia syndrome: A rare complication of pancreatic pathology. Radiol Case Rep 2023; 18:2001-2004. [PMID: 37020599 PMCID: PMC10068013 DOI: 10.1016/j.radcr.2023.02.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 02/23/2023] [Accepted: 02/26/2023] [Indexed: 04/05/2023] Open
Abstract
Pancreatitis, panniculitis, and polyarthralgia (PPP) syndrome is a rare complication of chronic pancreatitis and occurs due to leakage of pancreatic enzymes in the systemic vasculature. This enzyme leakage leads to multiple manifestations such as polyarthralgia, panniculitis, and bone necrosis due to tissue autodigestion.The inciting pancreatic pathology may be masked, and the presentation may be due to one of the systemic consequences of enzyme leakage, which can present as a diagnostic challenge for clinicians. Here we present a patient who presented with nodular lesions and bone necrosis, and was found to have PPP syndrome. Therefore, a proper understanding of pathophysiology and radiology findings can help with prompt diagnosis and early exploration of management options.
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Affiliation(s)
- Harjinder Singh
- Henry Ford Health, Department of Internal Medicine, Henry Ford Jackson Hospital, 205 N East Ave, Jackson, MI, 49201, USA
- Corresponding author.
| | - Parth Patel
- Henry Ford Health, Department of Internal Medicine, Henry Ford Jackson Hospital, 205 N East Ave, Jackson, MI, 49201, USA
| | - Shamik Parikh
- Henry Ford Health, Department of Internal Medicine, Henry Ford Jackson Hospital, 205 N East Ave, Jackson, MI, 49201, USA
| | - Hassan Zreik
- Henry Ford Health, Department of Internal Medicine, Henry Ford Jackson Hospital, 205 N East Ave, Jackson, MI, 49201, USA
| | - Neil Caliman
- Henry Ford Health, Department of Pathology, Henry Ford Jackson Hospital, 205 N East Ave, Jackson, MI, 49201, USA
| | - Vivek Kak
- Henry Ford Health, Department of Internal Medicine, Henry Ford Jackson Hospital, 205 N East Ave, Jackson, MI, 49201, USA
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19
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McElvaney OF, Fraughen DD, McElvaney OJ, Carroll TP, McElvaney NG. Alpha-1 antitrypsin deficiency: current therapy and emerging targets. Expert Rev Respir Med 2023; 17:191-202. [PMID: 36896570 DOI: 10.1080/17476348.2023.2174973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
INTRODUCTION Alpha1 antitrypsin deficiency (AATD), a common hereditary disorder affecting mainly lungs, liver and skin has been the focus of some of the most exciting therapeutic approaches in medicine in the past 5 years. In this review, we discuss the therapies presently available for the different manifestations of AATD and new therapies in the pipeline. AREAS COVERED We review therapeutic options for the individual lung, liver and skin manifestations of AATD along with approaches which aim to treat all three. Along with this renewed interest in treating AATD come challenges. How is AAT best delivered to the lung? What is the desired level of AAT in the circulation and lungs which therapeutics should aim to provide? Will treating the liver disease increase the potential for lung disease? Are there treatments to target the underlying genetic defect with the potential to prevent all aspects of AATDrelated disease? EXPERT OPINION With a relatively small population able to participate in clinical studies, increased awareness and diagnosis of AATD is urgently needed. Better, more sensitive clinical parameters will assist in the generation of acceptable and robust evidence of therapeutic effect for current and emerging treatments.
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Affiliation(s)
- Oisín F McElvaney
- Irish Centre for Genetic Lung Disease, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Medicine, Beaumont Hospital, Dublin, Ireland
| | - Daniel D Fraughen
- Irish Centre for Genetic Lung Disease, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Medicine, Beaumont Hospital, Dublin, Ireland
| | - Oliver J McElvaney
- Irish Centre for Genetic Lung Disease, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Medicine, Beaumont Hospital, Dublin, Ireland
| | - Tomás P Carroll
- Irish Centre for Genetic Lung Disease, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Medicine, Beaumont Hospital, Dublin, Ireland.,Alpha-1 Foundation Ireland, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Noel G McElvaney
- Irish Centre for Genetic Lung Disease, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Medicine, Beaumont Hospital, Dublin, Ireland
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20
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Lee YS, Lee JH, Han TY, Choi JE. A Rare Case of Localized Hypertrichosis in Conjunction with Erythema Nodosum. Int J Trichology 2023; 15:74-76. [PMID: 37701553 PMCID: PMC10495067 DOI: 10.4103/ijt.ijt_167_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 09/14/2023] Open
Abstract
Acquired hypertrichosis can occur in local inflammation. Erythema nodosum (EN) is a hypersensitivity reaction to various underlying antigenic stimuli including Mycobacterium tuberculosis, which causes inflammation in the septa of subcutaneous fat. There were several case reports that describe the association of localized hypertrichosis (LH) with traumatic panniculitis and lupus panniculitis. To our knowledge, this is the first reported case of acquired LH associated with EN. Thus, EN can be added to the list of causes of localized hypertrichosis.
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Affiliation(s)
- Yeon Seok Lee
- Department of Dermatology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - June Hyunkyung Lee
- Department of Dermatology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Tae Young Han
- Department of Dermatology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Jae Eun Choi
- Department of Dermatology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
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21
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Dhanasekaran M, Sandooja R, Higgins AS, Simha V. Marked Hypoleptinemia Precedes Overt Fat Loss in Immune Checkpoint Inhibitor-induced Acquired Generalized Lipodystrophy. JCEM Case Rep 2023; 1:luad025. [PMID: 37908472 PMCID: PMC10580409 DOI: 10.1210/jcemcr/luad025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Indexed: 11/02/2023]
Abstract
Immune checkpoint inhibitors (ICIs) targeting cancer cells that evade immune T-cell regulation have revolutionized the treatment of metastatic carcinomas. Unfortunately, secondary endocrinopathies associated with ICI, including adrenal insufficiency, primary hypothyroidism, autoimmune diabetes, and rarely hypoparathyroidism, are increasing. Lipodystrophy, presumably due to the autoimmune destruction of adipocytes, leading to metabolic complications, is a less recognized adverse effect of ICI therapy. We present a case of a 66-year-old Caucasian woman treated with pembrolizumab, an anti-programmed death 1 inhibitor, for metastatic lung adenocarcinoma. Fifteen months after the treatment initiation, she was found to have hyperglycemia, hyperlipidemia, and hepatic steatosis but without any evidence of autoimmune diabetes. She was also noted to have isolated buccal fat pad loss, raising suspicion of acquired lipodystrophy. Despite well-preserved subcutaneous fat over the trunk and limbs, she had undetectable serum leptin levels. Whole-body fluorodeoxyglucose (FDG)-positron emission tomography scan showed diffuse mild FDG activity throughout the subcutaneous tissue, suggesting underlying inflammation. Over the next 3 months, she developed progressive fat loss leading to generalized lipodystrophy. Adipose tissue dysfunction, secondary to ICI-induced subclinical panniculitis, precedes overt fat loss and is characterized by hypoleptinemia and metabolic abnormalities.
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Affiliation(s)
| | - Rashi Sandooja
- Department of Endocrinology, Diabetes and Nutrition, Mayo Clinic, Rochester, MN, USA
| | | | - Vinaya Simha
- Department of Endocrinology, Diabetes and Nutrition, Mayo Clinic, Rochester, MN, USA
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22
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Király Z, Kovács A, Medvecz M, Róbert L, Bokor L, Kuroli E, Szepesi Á, Marschalkó M, Hidvégi B. [Characteristics of the course of lupus erythematosus panniculitis in a retrospective analysis of 17 patients]. Orv Hetil 2023; 164:172-178. [PMID: 36739549 DOI: 10.1556/650.2023.32692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 11/27/2022] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Lupus erythematous panniculitis (LEP) is a rare type of chronic cutaneous lupus erythematous. Clinical characteristics are tender, subcutaneous nodules, erythematous plaques. Disfigurement of face and body might develop which affects the patient's quality of life. LEP can be the first sign of systemic lupus erythematous (SLE). OBJECTIVE Our aim was to review the clinicopathological characteristics and the course of LEP through our own patients. METHODS We retrospectively analyzed the clinical records of 17 LEP patients at Semmelweis University's Department of Dermatology, Venerology and Dermatooncology between 2000 and 2022. RESULTS The male : female ratio was 1 : 16, average age was 37.8 years. Lesion localisations were proximal lower (8/17) and upper extremities (7/17), face (4/17), breast (3/17), chest (2/17), buttocks (2/17), back (1/17) and distal lower extremity (1/17). Lesion morphologies were nodules (11/17), plaques (7/17), lipoatrophy (4/17), ulceration (3/17), calcification (1/17). Discoid changes covered in 6 cases. In 10 cases, systemic symptoms were observed (arthritis (4/17), haematological (5/17), renal (2/17), anti-phospholipid syndrome (2/17). 7 patients fulfilled the EULAR/ACR criteria for SLE. Histology showed mixed type panniculitis in 8, lobular in 3 cases. Average time until diagnosis was 24.3 months. Among all our SLE patients, skin symptoms regressed following systemic immunosuppressive treatment. LEP patients with only skin manifestation were often resistant for the therapy of cutaneous lupus erythematous. CONCLUSION The diagnosis of LEP often takes months or years. Wider knowledge of LEP would shorten the time to diagnosis, preventing disfigurement and possible damage of internal organs. Based on our observations, LEP without SLE might be treated with early immunosuppression. Orv Hetil. 2023; 164(5): 172-178.
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Affiliation(s)
- Zsófia Király
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest, Mária u. 41., 1085 Magyarország
| | - Anikó Kovács
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest, Mária u. 41., 1085 Magyarország
| | - Márta Medvecz
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest, Mária u. 41., 1085 Magyarország
| | - Lili Róbert
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest, Mária u. 41., 1085 Magyarország
| | - Laura Bokor
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest, Mária u. 41., 1085 Magyarország
| | - Enikő Kuroli
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest, Mária u. 41., 1085 Magyarország.,2 Semmelweis Egyetem, Általános Orvostudományi Kar, Patológiai és Kísérleti Rákkutató Intézet Budapest Magyarország
| | - Ágota Szepesi
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Patológiai és Kísérleti Rákkutató Intézet Budapest Magyarország
| | - Márta Marschalkó
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest, Mária u. 41., 1085 Magyarország
| | - Bernadett Hidvégi
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Bőr-, Nemikórtani és Bőronkológiai Klinika Budapest, Mária u. 41., 1085 Magyarország
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23
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Salma N, Wang-Evers M, Casper MJ, Karasik D, Andrade YJ, Tannous Z, Manstein D. Mouse model of selective cryolipolysis. Lasers Surg Med 2023; 55:126-134. [PMID: 35819225 DOI: 10.1002/lsm.23573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/28/2022] [Accepted: 05/25/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Cryolipolysis is a noninvasive method of destroying adipocytes using controlled cooling, thereby enabling localized and targeted fat reduction. Due to their greater vulnerability to cold injury, adipocytes are selectively targeted, while other cell types are spared. OBJECTIVES This study aims to develop a mouse model of cryolipolysis to offer a reliable and convenient alternative to human models, providing a methodology to validate clinical hypotheses in-depth with relative ease, low cost, and efficiency. This further facilitates comprehensive studies of the molecular mechanisms involved in cryolipolysis. MATERIALS AND METHODS Mice (C57BL/6J) were placed under general anesthesia and were treated using our custom, miniaturized cryolipolysis system. A thermoelectric cooling probe was applied to the inguinal (ING) area for either a cold exposure of -10°C, or for a room temperature exposure for 10 minutes. The thickness of the subcutaneous fat of the mice was quantified using an optical coherence tomography (OCT) imaging system before and after the treatment. Histological analyses were performed before and after cryolipolysis at multiple time points. RESULTS OCT analysis showed that mice that underwent cold cryolipolysis treatment induced a significantly greater reduction of subcutaneous fat thickness 1 month after treatment than the control mice. The mice that received cold treatment had no skin injuries. The selective damage of adipocytes stimulated cold panniculitis that was characterized histologically by infiltration of immune cells 2 and 3 days after treatment. CONCLUSION This study shows that cryolipolysis performed in mice yields reproducible and measurable subcutaneous fat reduction, consistent with previous studies conducted in humans and pigs. Future studies can utilize the model of selective cryolipolysis developed by our group to further elucidate the cellular and molecular mechanisms of fat cell loss and improve clinical outcomes in humans.
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Affiliation(s)
- Nunciada Salma
- Department of Dermatology, Cutaneous Biology Research Center (CBRC), Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Michael Wang-Evers
- Department of Dermatology, Cutaneous Biology Research Center (CBRC), Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Malte Johannes Casper
- Department of Biomedical Engineering, Laboratory for Functional Optical Imaging, Columbia University, New York, New York, USA
| | - Daniel Karasik
- Department of Dermatology, Cutaneous Biology Research Center (CBRC), Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Yanek Jiménez Andrade
- Department of Dermatology, Cutaneous Biology Research Center (CBRC), Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Zeina Tannous
- Department of Dermatology, School of Medicine, Lebanese American University, Beirut, Lebanon.,Department of Dermatology, Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Dieter Manstein
- Department of Dermatology, Cutaneous Biology Research Center (CBRC), Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
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24
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Ausín-García C, Cervilla-Muñoz E, Demelo-Rodríguez P, Villalba-García MV, Alvarez-Sala Walther LA. Visceral extra-abdominal panniculitis after COVID19. Int J Rheum Dis 2022; 26:793-796. [PMID: 36565466 DOI: 10.1111/1756-185x.14544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 11/29/2022] [Accepted: 12/10/2022] [Indexed: 12/25/2022]
Abstract
"Retractile mesenteritis" was the first name given to a rare, benign, inflammatory disease that affects the adipose tissue of the intestinal mesentery and less frequently other locations. Now labeled as mesenteric panniculitis, the pathogenic mechanism remains unclear. Several stimuli could be involved, and it is sometimes associated with other conditions such as malignancy or autoimmune diseases. We present a case of mesenteric panniculitis with extensive abdominal and extra-abdominal involvement that developed a few months after SARS-COV2 infection, raising the hypothesis of this virus as a potential trigger for autoinflammatory and autoimmune diseases.
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Affiliation(s)
- Cristina Ausín-García
- Internal Medicine Service, General University Hospital Gregorio Marañón, Madrid, Spain
| | - Eva Cervilla-Muñoz
- Internal Medicine Service, General University Hospital Gregorio Marañón, Madrid, Spain
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25
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Siegel LH, Fraile Alonso C, Tuazon CFR, Mancini AJ, Kruse LL, Miller JL, Wagner AM, Yun D, Kenner-Bell BM, Paller AS, Chamlin SL. Subcutaneous fat necrosis of the newborn: A retrospective study of 32 infants and care algorithm. Pediatr Dermatol 2022; 40:413-421. [PMID: 36544364 DOI: 10.1111/pde.15219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/24/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To describe the clinical and laboratory outcomes of infants with subcutaneous fat necrosis of the newborn (SCFN) and propose a care algorithm. METHODS This single-center, retrospective study of infants diagnosed with SCFN at Ann & Robert H. Lurie Children's Hospital of Chicago from 2009 to 2019. RESULTS Of 32 infants who met inclusion criteria, most were born full-term (84%), born via cesarean section (58%), had normal weight for gestational age (69%), and experienced delivery complications (53%). Twenty-nine infants (91%) had calcium drawn, and all had hypercalcemia. Three infants developed clinical symptoms of hypercalcemia, two required hospital admission, two developed nephrocalcinosis, and one developed acute kidney injury. The majority of infants (62%) had a peak ionized calcium between 1.5 and 1.6 mmol/L. No infants with peak ionized calcium less than 1.5 mmol/L developed complications of hypercalcemia. Most patients were diagnosed with hypercalcemia (86%) and demonstrated peak ionized calcium levels (59%) within the first 28 days of life. No patients developed hypercalcemia after 3 months of age. CONCLUSION Hypercalcemia occurred in 100% of infants who had laboratory monitoring. We recommend obtaining an initial ionized calcium level when SCFN is suspected, and monitoring for the first 3 months of life if hypercalcemia has not been detected. In patients with asymptomatic hypercalcemia less than 1.5 mmol/L, there appears to be low likelihood of related complications. For symptomatic, markedly elevated (>1.6 mmol/L), or persistently elevated levels (>6 months) we suggest coordinated care with endocrinology or nephrology, consider hospitalization, and urinary system ultrasound.
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Affiliation(s)
- Liza H Siegel
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Carmen Fraile Alonso
- Division of Dermatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Camelia Faye R Tuazon
- Division of Dermatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Anthony J Mancini
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Division of Dermatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Lacey L Kruse
- Division of Dermatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Jennifer L Miller
- Division of Endocrinology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Annette M Wagner
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Division of Dermatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Duri Yun
- Division of Dermatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Brandi M Kenner-Bell
- Division of Dermatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Amy S Paller
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Division of Dermatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Sarah L Chamlin
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Division of Dermatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
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26
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Muacevic A, Adler JR, Branco JC, Silva I. A Tricky Diagnosis of Poncet's Disease. Cureus 2022; 14:e32972. [PMID: 36712761 PMCID: PMC9876735 DOI: 10.7759/cureus.32972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2022] [Indexed: 12/28/2022] Open
Abstract
Erythema nodosum (EN) is a type of panniculitis often benign and self-limited. It may, however, be associated with numerous causes, the most common being infections (namely streptococcal infections), of which tuberculosis (TB) is also one. We report the case of a 43-year-old woman who was referred to our outpatient department with signs of a recurrent EN along with an asymmetrical oligoarthritis of the lower limbs. The investigation excluded all etiological causes of EN, except the interferon gamma release assay (IGRA) which was positive. It was assumed a latent TB infection was the cause of EN. Treatment with isoniazid was started, besides prednisolone and colchicine, with maintained clinical remission. There are just a few cases published about this subject and this intends to emphasize the importance of medical history and of an exhaustive search for a cause, as it may slip away due to the absence of symptoms.
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27
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Harview CL, Chen A, Stone M, Fairley J. Rapid cytologic diagnosis of subcutaneous fat necrosis of the newborn. Pediatr Dermatol 2022; 40:387-388. [PMID: 36411587 DOI: 10.1111/pde.15194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 11/01/2022] [Indexed: 11/23/2022]
Abstract
Subcutaneous fat necrosis of the newborn is a rare self-limited panniculitis that classically presents within the first few weeks of life. The diagnosis is typically clinical, but some cases require skin biopsy with hematoxylin and eosin stain for confirmation. We report a previously undocumented rapid diagnostic protocol that involves collecting a small amount of exudate from a suppurative lesion, placement onto a slide without fixation, and simply viewing the material under a microscope. This novel and practical method of diagnosis reveals doubly refractile crystals diagnostic of subcutaneous fat necrosis without a biopsy, which may be helpful for rapid diagnosis or use in low resource settings.
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Affiliation(s)
- Christina L Harview
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Ailynna Chen
- University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Mary Stone
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Janet Fairley
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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Abstract
BACKGROUND Over the course of the pandemic, cutaneous manifestations of SARS-CoV-2 infections have been increasingly characterized, yet only a few cases of erythema nodosum (EN) are reported in the literature and international registries. CASE PRESENTATION In this report, we describe a case of tender, erythematous nodules that appeared acutely on the distal legs in a 48-year-old female with renal transplant following SARSs-CoV-2 infection complicated by prolonged fevers and pneumonia. The patient was diagnosed with a classic presentation of EN arising from a new and emerging trigger-COVID-19 infection. The cutaneous lesions resolved with conservative management. CONCLUSIONS This report highlights the importance of clinician awareness of the potential association of COVID-19 with a classic clinical presentation of EN and underscores that these cases can be managed with the same therapeutic repertoire as EN due to other aetiologies. Of note, use of systemic agents was not employed in this case, as our patient improved with conservative therapy alone.
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Affiliation(s)
- Eva R Parker
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Ashli Fitzpatrick
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, United States
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29
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Sahraei Z, Abtahi-Naeini B, Saffaei A. Sputnik-V vaccine-induced panniculitis as a local reactions. Clin Case Rep 2022; 10:e05923. [PMID: 35662784 PMCID: PMC9163468 DOI: 10.1002/ccr3.5923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 05/06/2022] [Accepted: 05/17/2022] [Indexed: 11/23/2022] Open
Abstract
Here, a case of Sputnik‐V vaccine‐induced panniculitis was reported. The patient developed erythema, induration, and local tenderness at the injection site after 13 days of the injection. Ultra‐sonography imaging showed inflammation in subcutaneous layers including fat tissue compatible with panniculitis. She received ibuprofen and warm compress, and all symptoms resolved.
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Affiliation(s)
- Zahra Sahraei
- Department of Clinical Pharmacy School of Pharmacy Shahid Beheshti University of Medical Sciences Tehran Iran.,Skull Base Research Center Shahid Beheshti University of Medical Sciences Loghman Hakim Hospital Tehran Iran
| | - Bahareh Abtahi-Naeini
- Pediatric Dermatology Division of Department of Pediatrics Imam Hossein Children's Hospital, Isfahan University of Medical Sciences Isfahan Iran.,Skin Diseases and Leishmaniasis Research Center Isfahan University of Medical Sciences Isfahan Iran
| | - Ali Saffaei
- Department of Clinical Pharmacy School of Pharmacy Shahid Beheshti University of Medical Sciences Tehran Iran.,Skull Base Research Center Shahid Beheshti University of Medical Sciences Loghman Hakim Hospital Tehran Iran
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30
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Ginter DC, Ramien ML, Brundler MA, Swaney LC, Miettunen PM, Luca NJ. A rare case of suspected lupus erythematous panniculitis as the presenting skin feature of juvenile dermatomyositis: A case report. SAGE Open Med Case Rep 2022; 10:2050313X221086317. [PMID: 35355853 PMCID: PMC8958673 DOI: 10.1177/2050313x221086317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Juvenile dermatomyositis is a rare autoimmune myopathy of childhood, associated with systemic vasculopathy, primarily affecting the capillaries. Panniculitis is seen histologically in about 10% of patients with dermatomyositis; however, its clinical presentation is rare, with only 30 cases presented in the literature to date. The histopathology overlaps with other inflammatory disease states, and is almost identical to the panniculitis seen in lupus erythematous panniculitis. In the cases with both panniculitis and dermatomyositis, skin and muscle inflammation is usually the first clinical manifestation. We present a case of a 16-year-old female with panniculitis as the initial presenting feature of juvenile dermatomyositis in the context of a prior diagnosis of indeterminate colitis.
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Affiliation(s)
- Dylan C Ginter
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Michele L Ramien
- Division of Community Pediatrics, Department of Pediatrics, and Division of Dermatology, Department of Medicine, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada
| | - Marie-Anne Brundler
- Department of Pathology and Laboratory Medicine and Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Laura C Swaney
- Division of General Pediatrics, Department of Pediatrics, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Paivi Mh Miettunen
- Section of Pediatric Rheumatology, Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada
| | - Nadia Jc Luca
- Section of Pediatric Rheumatology, Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada
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31
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Hamie L, Abbas O, Kanj-Sharara S, Abou Rahal J. Erythema induratum of Bazin after intravesical Bacillus Calmette-Guérin immunotherapy. Clin Exp Pharmacol Physiol 2022; 49:544-545. [PMID: 35119123 DOI: 10.1111/1440-1681.13619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 12/02/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Lamiaa Hamie
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ossama Abbas
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Souha Kanj-Sharara
- Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Jihane Abou Rahal
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
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32
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Lin Q, Li J. Ultrasound analysis for pancreatic panniculitis: A case report. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2022; 47:139-142. [PMID: 35545374 PMCID: PMC10930483 DOI: 10.11817/j.issn.1672-7347.2022.210523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Indexed: 06/15/2023]
Abstract
Pancreatic panniculitis (PP) is a necrotizing inflammation of subcutaneous fat that is a rare complication of pancreatic disease appearing in 2% to 3% of all patients. It is more common in the elderly and often affects the extremities. It presents as skin inflammation with pain and erythema nodules. We report a case of acute pancreatitis associated with PP in an old female. She was admitted for vomiting and abdominal pain for 3 days and presented with a 2-week history of erythematous subcutaneous nodules on her legs. Laboratory and ultrasonic findings revealed acute pancreatitis. High frequency ultrasound showed hypoechoic foci in subcutaneous soft tissue layer and adipose layer. Histopathological examination confirmed the diagnosis of PP. Nodules disappeared with the resolution of acute pancreatic inflammation. PP may be the first manifestation of pancreatic disease. Imaging features of this pathology are seldom described and ultrasonic diagnosis experience is worth to be accumulated.
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Affiliation(s)
- Qian Lin
- Department of Ultrasound, Second Medical Center; National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China.
| | - Junlai Li
- Department of Ultrasound, Second Medical Center; National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China
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33
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Pararajasingam A, Bradley RE, Evans J, Lowe A, Goodwin R, Jolles S. Case Report: Generalised Panniculitis as a Post-COVID-19 Presentation in Aicardi-Goutières Syndrome Treated With Ruxolitinib. Front Pediatr 2022; 10:837568. [PMID: 35547545 PMCID: PMC9085217 DOI: 10.3389/fped.2022.837568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/01/2022] [Indexed: 12/15/2022] Open
Abstract
Aicardi-Goutières syndrome (AGS) is a rare hereditary early-onset encephalopathy. The syndrome was first described in 1984, and is characterised by upregulation of the type I interferon (IFN) pathway, which is involved in the host immune response against viral infections, including SARS-CoV-2. Whilst defects in type I IFN pathways have been described in association with severe coronavirus disease 2019 (COVID-19), less is known about the outcomes of upregulation. We describe an unusual case of generalised panniculitis as a post-COVID-19 phenomenon in a child with AGS. Our patient was initially managed with systemic steroid therapy, but due to relapse of symptoms on weaning, an alternative therapy was sought. In this case, a novel use of ruxolitinib, a JAK inhibitor, has resulted in lasting remission without complications. We discuss the probable protective role of IFN upregulation following COVID-19 infection in AGS and possible immunological mechanisms driving the panniculitis and therapeutic response in our case.
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Affiliation(s)
- Abirami Pararajasingam
- Department of Dermatology, Aneurin Bevan University Health Board, Newport, United Kingdom
| | - Rachel E Bradley
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, United Kingdom
| | - Jennifer Evans
- Department of Paediatrics, University Hospital of Wales, Cardiff, United Kingdom
| | - Ashima Lowe
- Department of Dermatology, Aneurin Bevan University Health Board, Newport, United Kingdom
| | - Richard Goodwin
- Department of Dermatology, Aneurin Bevan University Health Board, Newport, United Kingdom
| | - Stephen Jolles
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, United Kingdom
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34
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35
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Limtong P, Suchonwanit P, Chanprapaph K, Rutnin S. Clinicopathological Characteristics Related to Etiologies of Erythema Nodosum: A 10-Year Retrospective Study. Clin Cosmet Investig Dermatol 2021; 14:1819-1829. [PMID: 34876828 PMCID: PMC8643131 DOI: 10.2147/ccid.s343351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/13/2021] [Indexed: 11/25/2022]
Abstract
Background Erythema nodosum (EN) is the most common panniculitis associated with a wide variety of conditions. Updated studies regarding the clinicopathological manifestations related to etiologies of EN and its prognosis are limited. Objective We aimed to explore the clinicopathological features in relation to the etiologies of EN and determine characteristics of disease recurrence and its predictive factors. Methods A total of 169 patients with biopsy-proven EN or septal panniculitis from January 2008 to September 2018 were retrospectively reviewed. Patients were classified as either idiopathic or secondary EN. Patients’ general information, clinical manifestations, investigations, and recurrence of EN were recorded. The details on histopathological findings were reviewed by a blinded dermatopathologist. Results The mean age at diagnosis of EN was 40.6 ± 17.3 years. The majority of patients (85.2%) were female. Idiopathic EN was found in 62.7% of patients. Tuberculosis (23.8%) and drugs (23.8%) were the leading causes of secondary EN. In univariate logistic regression analysis, lesions on upper extremities (p = 0.018), fever (p = 0.003), clinical lymphadenopathy (p < 0.001) favored secondary EN. Histopathologically, the presence of focal peripheral lobular panniculitis with eosinophils was linked to idiopathic EN (p = 0.03). However, multivariable logistic regression analysis failed to demonstrate factors associated with secondary EN. Recurrence was found in 46.6% of patients with no identifiable predictive factors. Conclusion Although no clinical risk factors were associated with the etiology of EN, the histopathological presence of eosinophils in focal peripheral lobular panniculitis suggested idiopathic EN.
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Affiliation(s)
- Preeyachat Limtong
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kumutnart Chanprapaph
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suthinee Rutnin
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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36
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Pan W, Wang Q, Yang M, Zhang L, Wang J, Sun K. Pancreatic carcinoma presented with panniculitis and polyarthritis: A rare case. J Cancer Res Ther 2021; 17:1751-1754. [PMID: 35381750 DOI: 10.4103/jcrt.jcrt_2386_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Extrapancreatic manifestations can complicate pancreatic disorders. Pancreatic panniculitis, characterized by subcutaneous fat necrosis, develops in 0.3%-3% of patients with pancreatic disorders. Occasionally, pancreatic panniculitis and polyarthritis occur in the same patient with pancreatic diseases, a rare symptomatic triad known as pancreatitis, panniculitis, and polyarthritis (PPP) syndrome. PPP syndrome is primarily caused by acute or chronic pancreatitis and pancreatic carcinoma. Almost half of the patients with PPP syndrome do not present with gastrointestinal signs, which may lead to a delayed diagnosis of underlying pancreatic disease. The skin and arthritic symptoms may be mistaken for rheumatic diseases. The histological finding of skin lesions is a valuable clue for diagnosing pancreatic diseases. Due to the high mortality rate when PPP syndrome is associated with pancreatic carcinoma, we highlight that the pancreas should be thoroughly examined if a skin biopsy indicates pancreatic panniculitis.
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Affiliation(s)
- Wenping Pan
- Department of Rheumatology, First Affiliated Hospital of Shandong First Medical University, Shandong Province, Jinan, China
| | - Qing Wang
- Department of Rheumatology, First Affiliated Hospital of Shandong First Medical University, Shandong Province, Jinan, China
| | - Min Yang
- Department of Pathology, First Affiliated Hospital of Shandong First Medical University, Shandong Province, Jinan, China
| | - Li Zhang
- Department of Ultrasonography, First Affiliated Hospital of Shandong First Medical University, Shandong Province, Jinan, China
| | - Jun Wang
- Department of Oncology, First Affiliated Hospital of Shandong First Medical University, Shandong Province, Jinan, China
| | - Kai Sun
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Shandong First Medical University, Shandong Province, Jinan, China
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37
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Dharmadji HP, Suwarsa O, Sutedja E, Pangastuti M, Gunawan H, Makarti K. Erythema Induratum of Bazin Accompanied by Atrophy of the Subcutaneous Fat. Int Med Case Rep J 2021; 14:777-781. [PMID: 34815719 PMCID: PMC8604635 DOI: 10.2147/imcrj.s336088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/31/2021] [Indexed: 11/23/2022] Open
Abstract
Erythema induratum of Bazin (EIB) is a predominantly lobular panniculitis with or without vasculitis due to Mycobacterium tuberculosis (MTB) infection. Atrophic scars may remain after EIB was healed. Rare cases of EIB showing sharp skin depression may mimic deep morphea and lupus profundus. A rare case of EIB was reported in a 35-year-old female with slightly tender erythematous-violaceous nodules and hyperpigmented depressed scars on both lower legs, resulting in asymmetrical lower leg shape. Histopathological examination showed lobular panniculitis without vasculitis and granulomatous inflammation consisted of caseous necrosis, epithelioid cells, and multinucleated giant cells. Polymerase chain reaction (PCR) from skin biopsy revealed deoxyribonucleic acid (DNA) of MTB. Tuberculin skin test (TST) was positive with a 20-mm induration, and nuclear 99mTc-ethambutol scintigraphy was positive for tuberculosis infection in one-third distal portion of the left lower leg. Clinical improvements were shown after 6 months of antituberculosis therapy. EIB must be considered in patient with erythematous-violaceous nodules on lower leg, especially in endemic areas of tuberculosis infection since diagnosis can be difficult and occasionally, deceptive.
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Affiliation(s)
- Hartati Purbo Dharmadji
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Oki Suwarsa
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Endang Sutedja
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Miranti Pangastuti
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Hendra Gunawan
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Kristina Makarti
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
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38
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Nazzaro G, Maronese CA, Passoni E. Ultrasonographic diagnosis of erythema nodosum. Skin Res Technol 2021; 28:361-364. [PMID: 34813122 PMCID: PMC9907651 DOI: 10.1111/srt.13112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 09/25/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Gianluca Nazzaro
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Alberto Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Emanuela Passoni
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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39
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Gosnell H, Burke M, Shnouda J. Ecthyma Gangrenosum and Panniculitis Secondary to Acute Pseudomonas Myositis Without Bacteremia. HCA Healthc J Med 2021; 2:345-348. [PMID: 37425122 PMCID: PMC10324735 DOI: 10.36518/2689-0216.1244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Introduction Ecthyma gangrenosum (EG) is a relatively uncommon cutaneous manifestation of an underlying Pseudomonas aeruginosa infection and is clinically described as necrotic with gangrenous ulcers surrounded by erythematous halos. Cases of EG may occur in the absence of bacteremia and have been increasingly reported in literature. Here we present a patient with features of both EG and panniculitis, despite the lack of underlying bacteremia. Clinical Findings A 57-year-old male presented to the emergency department with unrelenting right-sided lower back pain and an "itchy and painful" rash of four to five day duration. The patient had an extensive history of intravenous drug abuse and had been hospitalized multiple times for Pseudomonas bacteremia. Upon examination, there were diffuse, erythematous subcutaneous nodules and several individual necrotic ulcerations on the abdomen, upper and lower extremities, surrounded by erythematous halos. An MRI revealed myositis and edema in the right paraspinal region, and blood cultures were negative for Pseudomonas. Discussion EG is typically classified as bacteremic or non-bacteremic in nature, and there are limited reports of panniculitis in the absence of bacteremia. This patient's presentation was unusual for the diffuse presentation of non-bacteremic EG with panniculitis. Due to the patient's past medical history of deep-seeded Pseudomonas infections, bacteria could have been directly inoculated into the skin at various injection sites. Conclusion While EG is an uncommon but well-recognized dermatologic feature of Pseudomonas bacteremia, panniculitis is reportedly less commonly and likely underrecognized. Physicians should become aware of the cutaneous manifestations of underlying Pseudomonas infection so appropriate antibiotic therapy can be initiated.
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Affiliation(s)
- Heather Gosnell
- Lake Erie College of Osteopathic Medicine Education, Erie, PA
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40
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Touhouche TA, Tournier E, Lamant L, Hardy J, Taieb A, Labreze C, Cony M, Lepreux S, Chiaverini C, Lacour JP, Cardot-Leccia N, Bedane C, Assikar S, Charissoux A, Mazereeuw-Hautier J. Annular lipoatrophy of the ankle: Four new pediatric cases and a review of the literature. Pediatr Dermatol 2021; 38:1292-1297. [PMID: 34418138 DOI: 10.1111/pde.14670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Annular lipoatrophy of the ankle is a rare and unique acquired lipoatrophic panniculitis that mainly affects children. There is no consensus on treatment, and the long-term course is not well known. We present four new pediatric cases that contribute to the understanding of this rare disease.
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Affiliation(s)
- Timila Assia Touhouche
- University Hospital, Larrey Hospital, Dermatology Department, Paul Sabatier University, Reference Centre for Rare Skin Diseases Toulouse, Toulouse, France
| | - Emilie Tournier
- Department of Pathology, University Cancer Institute, Oncopole, Toulouse, France
| | - Laurence Lamant
- Department of Pathology, University Cancer Institute, Oncopole, Toulouse, France
| | - Juliette Hardy
- University Hospital, Larrey Hospital, Dermatology Department, Paul Sabatier University, Reference Centre for Rare Skin Diseases Toulouse, Toulouse, France
| | - Alain Taieb
- University Hospital Center, Dermatology Department, Reference Centre for Rare Skin Diseases, Bordeaux, France
| | - Christine Labreze
- University Hospital Center, Dermatology Department, Reference Centre for Rare Skin Diseases, Bordeaux, France
| | - Marianne Cony
- University Hospital Center, Dermatology Department, Reference Centre for Rare Skin Diseases, Bordeaux, France
| | - Sebastien Lepreux
- Department of Pathology, University Hospital Center, Bordeaux, France
| | - Christine Chiaverini
- University Hospital Center, Dermatology Department, Reference Centre for Rare Skin Diseases, Nice, France
| | - Jean Philippe Lacour
- University Hospital Center, Dermatology Department, Reference Centre for Rare Skin Diseases, Nice, France
| | | | - Christophe Bedane
- Department of Dermatology, Dupuytren Hospital, University Hospital Center, Limoges, France
| | - Safae Assikar
- Department of Dermatology, Dupuytren Hospital, University Hospital Center, Limoges, France
| | - Aurélie Charissoux
- Department of Dermatology, Dupuytren Hospital, University Hospital Center, Limoges, France
| | - Juliette Mazereeuw-Hautier
- University Hospital, Larrey Hospital, Dermatology Department, Paul Sabatier University, Reference Centre for Rare Skin Diseases Toulouse, Toulouse, France
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41
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Tejwani V, Stoller JK. The spectrum of clinical sequelae associated with alpha-1 antitrypsin deficiency. Ther Adv Chronic Dis 2021; 12_suppl:2040622321995691. [PMID: 34408829 PMCID: PMC8367210 DOI: 10.1177/2040622321995691] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 01/26/2021] [Indexed: 01/19/2023] Open
Abstract
Alpha-1 antitrypsin (AAT) deficiency (AATD) is an autosomal co-dominant condition that predisposes to the development of lung disease, primarily emphysema. Emphysema results from the breakdown of lung matrix elastin by proteases, including neutrophil elastase, a protease normally inhibited by AAT. AATD also predisposes to liver (cirrhosis) and skin (panniculitis) disease, and to vasculitis. The prevalence of AATD is estimated to be approximately 1 in 3,500 individuals in the United States. However, lack of awareness of AATD among some physicians, misperceptions regarding the absence of effective therapy, and the close overlap in symptoms with asthma and non-AATD chronic obstructive pulmonary disease are thought to contribute to under-recognition of the disease. In patients with AATD, treatment with intravenous AAT augmentation therapy is the only currently available treatment known to slow the progression of emphysema. Moreover, smoking cessation and other lifestyle interventions also help improve outcomes. Early diagnosis and intervention are of key importance due to the irreversible nature of the resultant emphysema. Liver disease is the second leading cause of death among patients with AATD and a minority of patients present with panniculitis or antineutrophil cytoplasmic antibody-associated vasculitis, thought to be directly related to AATD. Though no randomized trial has assessed the effectiveness of augmentation therapy for AATD-associated panniculitis, clinical experience and case series suggest there is a benefit. Other diseases putatively linked to AATD include aneurysmal disease and multiple neurological conditions, although these associations remain speculative in nature.
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Affiliation(s)
- Vickram Tejwani
- Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James K Stoller
- Education Institute, NA22, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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42
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Kishida D, Ushiyama S, Shimojima Y, Ueno KI, Kurashina JI, Shirai T, Sekijima Y. Painless Panniculitis upon the Treatment of Clinically Amyopathic Dermatomyositis with Anti-MDA5 Antibody. Intern Med 2021; 60:2697-2700. [PMID: 33678748 PMCID: PMC8429278 DOI: 10.2169/internalmedicine.6931-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Panniculitis, a rare cutaneous manifestation in patients with dermatomyositis (DM), usually presents as a painful erythematous lesion. We herein report a 32-year-old woman with panniculitis that appeared as an indurated plaque without pain or redness after a 4-month episode of clinically amyopathic DM during treatment with prednisolone and tacrolimus. She experienced no pain; however, the firmness and extent gradually worsened. Based on our findings, including the histopathological results, DM panniculitis was diagnosed. Azathioprine was additionally administered, leading to remission. DM panniculitis can develop as a painless induration during immunosuppressive treatment, and azathioprine may be a useful treatment.
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Affiliation(s)
- Dai Kishida
- Department of Medicine (Neurology & Rheumatology), Shinshu University School of Medicine, Japan
| | - Satoru Ushiyama
- Department of Medicine (Neurology & Rheumatology), Shinshu University School of Medicine, Japan
| | - Yasuhiro Shimojima
- Department of Medicine (Neurology & Rheumatology), Shinshu University School of Medicine, Japan
| | - Ken-Ichi Ueno
- Department of Medicine (Neurology & Rheumatology), Shinshu University School of Medicine, Japan
| | - Jun-Ichi Kurashina
- Department of Medicine (Neurology & Rheumatology), Shinshu University School of Medicine, Japan
| | - Takushi Shirai
- Department of Dermatology, Shinshu University School of Medicine, Japan
| | - Yoshiki Sekijima
- Department of Medicine (Neurology & Rheumatology), Shinshu University School of Medicine, Japan
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Wortsman X, Ferreira-Wortsman C. Ultrasound in Sports and Occupational Dermatology. J Ultrasound Med 2021; 40:1675-1692. [PMID: 33155699 DOI: 10.1002/jum.15550] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/06/2020] [Accepted: 10/12/2020] [Indexed: 06/11/2023]
Abstract
Chronic exposure to trauma, friction, or extreme conditions can generate cutaneous or ungual lesions in sports and certain occupations. Although some of these dermatologic conditions are diagnosed with a naked-eye examination, there are cases in which the provision of the underlying anatomic alterations can be helpful for the diagnosis and management. In comparison with computed tomography or magnetic resonance imaging, ultrasound has the highest axial resolution, which is critical for the observation of anatomic changes in the skin and nail. We review the ultrasound characteristics of frequent cutaneous and ungual lesions related to sports and occupations with a clinical correlation. The ultrasound features in some particular conditions such as "biker's and surfer's panniculitis," "fiddler's neck," piezogenic papules, and lipoatrophy semicircularis, among others, are discussed.
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Affiliation(s)
- Ximena Wortsman
- Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Santiago, Chile
- Department of Dermatology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
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Abstract
Panniculitides form a heterogenous group of inflammatory diseases that involve the subcutaneous adipose tissue. These disorders are rare in children and have many aetiologies. As in adults, the panniculitis can be the primary process in a systemic disorder or a secondary process that results from infection, trauma or exposure to medication. Some types of panniculitis are seen more commonly or exclusively in children, and several new entities have been described in recent years. Most types of panniculitis have the same clinical presentation (regardless of the aetiology), with tender, erythematous subcutaneous nodules. Although the patient's age and the lesion site provide information, a histopathological assessment is sometimes required for a definitive diagnosis and classification of the disorder. In children, most panniculitides are lobular. At present, autoimmune inflammatory diseases and primary immunodeficiencies have been better characterised; panniculitis can be the presenting symptom in some of these settings. Unexplained panniculitis in a young child should prompt a detailed screen for monogenic immune disorders because the latter usually manifest themselves early in life. Here, we review forms of panniculitis that occur primarily in children, with a focus on newly described entities.
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Affiliation(s)
- Isabelle Moulonguet
- Cabinet de Dermatopathologie Mathurin Moreau, 75019 Paris, France
- Dermatology Department, Hôpital Saint Louis, 75010 Paris, France
- Correspondence:
| | - Sylvie Fraitag
- Dermatopathology Department, Hospital Necker Enfants-Malades, 75006 Paris, France;
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45
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Affiliation(s)
- Hannah Pile
- Department of Dermatology, St. Joseph Mercy Hospital, Ann Arbor, Michigan
| | - Taylor Harp
- Rocky Vista University College of Osteopathic Medicine, Parker, Colorado
| | - David Altman
- Department of Dermatology, St. Joseph Mercy Hospital, Ann Arbor, Michigan
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46
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Pach J, Moody K, Ring N, Panse G, Zhang M, Deverapalli S, Leventhal J. Erythema nodosum-like panniculitis associated with immune checkpoint inhibitor therapy: Two cases reporting a rare cutaneous adverse event. JAAD Case Rep 2021; 13:118-120. [PMID: 34189226 PMCID: PMC8220292 DOI: 10.1016/j.jdcr.2021.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jolanta Pach
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Katherine Moody
- Department of Dermatology, Tufts University School of Medicine, Boston, Massachusetts
| | - Nan Ring
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Gauri Panse
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | | | - Sandhya Deverapalli
- Department of Dermatology, Tufts University School of Medicine, Boston, Massachusetts
| | - Jonathan Leventhal
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
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Zelman B, Bode-Omoleye O, Muhlbauer A, Agidi A, Mafee M, Velankar M, Mirza K, Speiser J, Mudaliar K. Chronic myeloid leukemia-leukemia cutis mimicking a neutrophilic panniculitis-like leukemia cutis: Report of a rare case. J Cutan Pathol 2021; 48:1277-1281. [PMID: 33891722 DOI: 10.1111/cup.14030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/15/2021] [Accepted: 04/06/2021] [Indexed: 11/29/2022]
Abstract
While drug-induced panniculitis is not uncommon in chronic myeloid leukemia (CML) patients on tyrosine kinase inhibitor therapy, it is rare for CML to initially present as a leukemic panniculitis. We present the case of a 45-year-old male with no relevant prior medical history presenting with 6 months of migratory nodules, 2 months of drenching night sweats, and a 20 pound weight loss. Physical examination showed firm subcutaneous nodules with overlying ecchymoses present on the right lateral thigh and left lower back. Biopsy of a nodule from the right thigh showed a subcutaneous lobular panniculitis involved by a dense infiltrate of neutrophils and granulocyte precursors. Fluorescent in-situ hybridization (FISH) was positive for t(9;22)(q34;q11.2)BCR-ABL1 fusion. A concurrent hemogram revealed a white blood cell count elevation of 600,000 K/μL. Bone marrow biopsy examination showed marked myeloid expansion with an increase in granulocyte precursors and Philadelphia chromosome positivity by FISH, consistent with bone marrow involvement by CML. Herein, we describe this unusual and rare case of CML initially presenting as a neutrophilic panniculitis-like leukemia cutis. Arriving at this challenging diagnosis may be easily missed without clinical and laboratory correlation, which would certainly lead to the patient's not receiving life-saving treatment.
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Affiliation(s)
- Brandon Zelman
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois, USA
| | | | - Aaron Muhlbauer
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois, USA
| | - Ada Agidi
- Department of Dermatology, Loyola University Medical Center, Maywood, Illinois, USA
| | - Mariam Mafee
- Department of Dermatology, Loyola University Medical Center, Maywood, Illinois, USA
| | - Milind Velankar
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois, USA
| | - Kamran Mirza
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois, USA
| | - Jodi Speiser
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois, USA
| | - Kumaran Mudaliar
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois, USA
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Abstract
With increasing numbers of pet rabbits living out their natural lifespan, rabbit oncology is stepping more and more into the limelight. On the other hand, rabbit tumors are less covered in recent editions of textbooks of veterinary pathology than before. We present 1238 cases with neoplastic and non-neoplastic masses in rabbit tissue, submitted from 2008 to 2019, supplemented by a review of the literature on neoplasms in rabbits. Cutaneous masses comprised 47% of submissions. Trichoblastoma was by far the most common skin neoplasm, and nodular suppurative panniculitis was the second most frequent skin nodule in this series. Epithelial as well as mesenchymal cutaneous neoplasms can be virally induced in rabbits (eg, Shope papilloma, myxomatosis) but were infrequent in the current cases. Mammary neoplasms comprised 21% of submitted masses and 94% of these had histologic features of malignancy. Tumors of the female reproductive tract were responsible for 9% of biopsies and were predominantly uterine adenocarcinoma. Polypoid proliferation of rectal mucosa was the most common lesion in the alimentary tract. A broad spectrum of other neoplasms was described, including sarcomas at vaccination sites and ocular posttraumatic sarcomas, comparable to lesions described in cats.
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Affiliation(s)
- Berit Baum
- Vet Med Labor GmbH, Kornwestheim, Germany
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49
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Garcia BM, Bond AR, Barry AK, Steen AJ, LeBoit PE, Ashbaugh C, Shinkai K. Disseminated-cutaneous sporotrichosis in an immunocompetent adult. JAAD Case Rep 2021; 11:102-4. [PMID: 33948469 DOI: 10.1016/j.jdcr.2021.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Michaelis TC, Sluzevich JC, Turbeville JG, Martinez JC. Longitudinal orientation of incisional biopsy specimens for improved histopathologic visualization. J Am Acad Dermatol 2021:S0190-9622(21)00630-7. [PMID: 33775717 DOI: 10.1016/j.jaad.2021.03.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 03/10/2021] [Indexed: 11/27/2022]
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