11/53. Pancreatic panniculitis in a kidney transplant recipient.BACKGROUND: Pancreatic panniculitis is a rare complication of pancreatic disease. Histopathologic findings are pathognomonic and may be helpful for early diagnosis. methods: We present a female kidney transplant recipient, with systemic lupus erythematosus on immunossuppresive therapy, who developed panniculitis. RESULTS: Histological features strongly suggested pancreatic panniculitis and this was confirmed by clinical, laboratory and image findings. CONCLUSION: The characteristic histologic features of pancreatic panniculitis may help to uncover undiagnosed pancreatic disease. Early therapy may avoid ensuing serious complications.- - - - - - - - - - ranking = 1keywords = erythema (Clic here for more details about this article) |
12/53. Acute brucellosis presenting with erythema nodosum.brucellosis is a common world-wide zoonotic disease. Cutaneous manifestations are not specific and affect 1-14% of patients with brucellosis. We describe two cases of young males presenting with skin lesions of erythema nodosum on the anterior surface of the legs. Histopathology of skin biopsy revealed septal panniculitis, but the positive cultures of blood or bone marrow for brucella melitensis established the diagnosis of brucellosis.- - - - - - - - - - ranking = 567.53389691615keywords = erythema nodosum, nodosum, erythema (Clic here for more details about this article) |
13/53. carcinoma of the pancreas with neuroendocrine differentiation and nodular panniculitis.BACKGROUND: On rare occasions tumours of the pancreas produce high amounts of pancreatic lipase. The enzyme activity in the blood and in different tissues causes a syndrome called nodular panniculitis by focal necrosis of lipids and a concomittant inflammatory reaction. CASE REPORT: A 72-year-old man was admitted to the dermatology clinic with the diagnosis of erythema nodosum. The patient had been well until 3 months earlier when painful red nodes developed on the skin of both shanks. He complained of profuse night sweating and a weight loss of 10 kg within that time but did not have fever. He also had noticed a painful swelling of his right index finger, left middle finger and the third toe on his left foot. biopsy of the nodes revealed a focal necrosis of fatty tissue. Laboratory examinations showed a highly elevated concentration of serum pancreatic lipase. Further investigations showed a tumour in the pancreas and several osteolytic lesions. Tumour biopsy revealed a neuroendocrine carcinoma. After tumour resection serum lipase level immediately fell to almost normal values, and all skin and bone manifestations disappeared quickly. CONCLUSION: Due to its clinical appearance the panniculitis syndrome is most often mistaken for either erythema nodosum or rheumatoid arthritis. A resection of the tumour after correct diagnosis should always be considered because the widespread manifestations in the skin and bones do not represent distant metastasis and have a very good chance to dissolve completely.- - - - - - - - - - ranking = 227.01355876646keywords = erythema nodosum, nodosum, erythema (Clic here for more details about this article) |
14/53. Neutrophilic panniculitis.Neutrophilic (lobular) panniculitis (NP) is a very rare condition that belongs to the group of neutrophilic dermatoses. We report the case of a patient with NP and review the relevant literature. NP appears as a subcutaneous nodular eruption. histology shows a lobular neutrophilic infiltrate. NP must be differentiated from other types of panniculitis, and also from the subcutaneous septal involvement that may occur in some cases of Sweet's syndrome and from erythema nodosum. NP is significantly associated with myelodysplasia. It is highly sensitive to oral steroid therapy.- - - - - - - - - - ranking = 113.50677938323keywords = erythema nodosum, nodosum, erythema (Clic here for more details about this article) |
15/53. Subcutaneous panniculitis-like T-cell lymphoma with vacuolar interface dermatitis resembling lupus erythematosus panniculitis.Lupus erythematosus (LE) panniculitis (LEP) is a form of chronic cutaneous LE most often characterized by erythematous subcutaneous nodules. The histopathology of LEP may be distinctive, allowing a diagnosis even in the absence of any other LE features. Lymphocytic infiltration of the panniculus is termed lymphocytic lobular panniculitis. This entity has been reported in both LEP and subcutaneous panniculitis-like T-cell lymphoma. We describe a 67-year-old woman who presented with multiple dermal and subcutaneous nodules on her legs and hips. biopsy specimens of roughly 15 lesions were interpreted as being diagnostic of LEP, however, with each subsequent biopsy specimen more atypical cells were observed. The patient responded only to moderate doses of oral prednisone, and failed intralesional triamcinolone acetonide, oral immunosuppressive agents, oral antimalarial agents, and oral thalidomide. Three years after the onset of her disease, ulcerated plaques and nodules developed. At this time a T-cell receptor gene rearrangement was present and subcutaneous panniculitis-like T-cell lymphoma was diagnosed. Despite multiple doses of chemotherapy she died approximately 1 year after diagnosis. patients with apparent LEP that have atypical lymphocytes in their biopsy specimens should be followed up closely for the development of T-cell malignancy.- - - - - - - - - - ranking = 6keywords = erythema (Clic here for more details about this article) |
16/53. Neutrophilic panniculitis with myelodysplastic syndromes presenting as pustulosis: case report and review of the literature.Neutrophilic panniculitis associated with myelodysplastic syndromes is rare. We report a 59-year-old patient who initially was diagnosed with myelodysplastic syndrome (MDS) and developed a sudden onset of widespread pustulosis and erythematous indurated papules. Examination of skin biopsies of a papule lesion showed dense neutrophilic infiltration limited to the subcutaneous tissue. The pustules and papules disappeared completely after treatment with systemic corticosteroids. To our knowledge, only one patient was identified by medline search of the English-language literature.- - - - - - - - - - ranking = 1keywords = erythema (Clic here for more details about this article) |
17/53. radiation recall dermatitis, panniculitis, and myositis following cyclophosphamide therapy: histopathologic findings of a patient affected by multiple myeloma.radiation recall dermatitis is one of the skin sequelae that may affect oncology patients. It occurs in a previously irradiated field, when subsequent chemotherapy is given. The eruption may be elicited by chemotherapy, even several months after radiotherapy. Its mechanism is poorly understood, and the histopathologic findings have received, to date, only sketchy descriptions. A 55-year-old male affected by multiple myeloma received radiation therapy both on his left coxofemoral area, and lumbar region (D11-L1). After cyclophosphamide administration, he developed 2 well defined square-shaped, infiltrated erythematoviolaceous plaques in the prior irradiated fields. Histopathologic findings revealed a diffusely fibrosclerosing process, involving deep dermis, hypodermis, as well as the underlying muscle, while sparing the epidermis and superficial-mid dermis. Histopathology was indistinguishable from deep radio-dermatitis, panniculitis, and myositis. This is the first case providing clear evidence of the causative role of cyclophosphamide in inducing a cutaneous and subcutaneous radiation recall reaction.- - - - - - - - - - ranking = 1keywords = erythema (Clic here for more details about this article) |
18/53. Small vessel vasculitis and relapsing panniculitis in tumour necrosis factor receptor associated periodic syndrome (TRAPS).case reports: A 66 year old female patient had relapsing fever and non-suppurative panniculitis suggestive of enigmatic "Weber-Christian disease" (WCD). Antineutrophil cytoplasmic antibodies with specificity for human leucocyte elastase (HLE-ANCA) were detected. A biopsy showed small vessel vasculitis and panniculitis. A 53 year old man had recurrent episodes of abdominal pain, erythematous rash, and myalgia. Fever attacks had stopped a few years ago. A biopsy showed panniculitis and fasciitis. In both patients mutations (R92Q, T50M) of the tumour necrosis factor receptor super family (TNFRSF) 1A gene were disclosed. Mutations of the TNFRSF 1A gene are the cause of tumour necrosis factor receptor associated periodic syndrome (TRAPS). Both patients responded favourably to treatment with the human soluble p75 TNF alpha receptor fusion protein etanercept (2 x 25 mg subcutaneously/week). DISCUSSION: Small vessel vasculitis and panniculitis have not been reported in TRAPS so far. The cases underline the importance of TNF alpha regulation in inflammatory processes including vasculitis. Genetically determined causes of fever may account for some cases of WCD.- - - - - - - - - - ranking = 1keywords = erythema (Clic here for more details about this article) |
19/53. From circumscribed scleroderma (morphea) to subcutaneous panniculitis-like T-cell lymphoma: case report.Subcutaneous panniculitis-like T-cell lymphoma is a rare form of non-Hodgkin lymphoma. It presents clinically as panniculitis, with erythematous, firm subcutaneous infiltrates and recurrent papulonodules. A 45-year-old male Croat presented with a 6-month history of tender erythematous subcutaneous skin lesions without systemic symptoms. Analysis of a lesion biopsy specimen showed circumscribed scleroderma (morphea). During hospitalization, skin biopsies from two subcutaneous lesions on the stomach were repeated, and pathohistologic analysis corresponded primarily to panniculitis in the context of morphea. Pathohistologic analysis and immunohistochemistry of a specimen obtained by tumor excision from the back indicated subcutaneous panniculitis-like T-cell lymphoma. Histologic analysis revealed a dense infiltrate of atypical T-lymphoid cells expressing CD8( ) phenotype located in the subcutaneous tissue with histiocyte-phagocytizing apoptotic cells. Specific hematologic analysis and medical treatment were continued. This case report illustrates the importance of continuous follow-up with repeat biopsy and use of immunohistologic techniques for early diagnosis.- - - - - - - - - - ranking = 2keywords = erythema (Clic here for more details about this article) |
20/53. Fatal subcutaneous panniculitis-like T-cell lymphoma with interface change and dermal mucin, a dead ringer for lupus erythematosus.We report a 48-year-old man who presented with ulcerated plaques and nodules of the lower extremities. skin biopsies revealed a dense lymphocytic infiltrate involving the dermis and the subcutis in a lobular and septal pattern. No overt cytological atypia was present. Notably, several features resembling lupus erythematosus were present, including vacuolar interface change and abundant dermal mucin deposition. The patient developed pulmonary nodules, and a lung biopsy showed a perivascular and interstitial lymphoid infiltrate without overt atypia. The cutaneous and pulmonary lymphoid infiltrates showed similar immunohistochemical profiles: CD3( ) CD4(-) CD8( /-) CD56( ). Monoclonal rearrangements of the T-cell receptor gamma gene with similar migration patterns were identified from both locations. The patient developed fatal hemophagocytic syndrome, involving liver, spleen, lymph nodes, and bone marrow. This case is one amongst the rare reports of subcutaneous panniculitis-like T-cell lymphoma with systemic involvement.- - - - - - - - - - ranking = 5keywords = erythema (Clic here for more details about this article) |
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