Panniculitis describes inflammation of the subcutaneous fat that can result from multiple causes. Diagnosis is by clinical evaluation and biopsy. Treatment depends on the cause.
Panniculitis can be classified as lobular or septal depending on the principal site of the inflammation within the fat.
There are multiple causes of panniculitis, including
Idiopathic panniculitis is sometimes referred to as Weber-Christian disease.
Symptoms and Signs
Panniculitis is characterized by tender and erythematous subcutaneous nodules located over the extremities and sometimes over the posterior thorax, abdominal area, breasts, face, or buttocks. Rarely, nodules can involve the mesentery, lungs, scrotum, and cranium. Signs of systemic inflammation can accompany panniculitis. In Weber-Christian disease, systemic involvement can result in fever as well as signs of organ dysfunction, including hepatic, pancreatic, and bone marrow insufficiency, which is potentially fatal.
Diagnosis is by usually by clinical appearance and can be confirmed by excisional biopsy.
There is no specific definitive treatment for panniculitis. Several strategies have been used with modest results, including NSAIDs, antimalarials, dapsone, and thalidomide. Corticosteroids (1 to 2 mg/kg po or IV once/day) and other immunosuppressive or chemotherapeutic drugs have been used to treat patients with progressive symptoms or signs of systemic involvement.
Last full review/revision November 2013 by Wingfield E. Rehmus, MD, MPH
Content last modified November 2013