Merck Manual

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Julia Benedetti

, MD, Harvard Medical School

Last full review/revision Sep 2020| Content last modified Sep 2020
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Panniculitis is inflammation of the fat layer beneath the skin.

  • Panniculitis has many causes.

  • Typical symptoms include tender, red bumps under the skin.

  • The diagnosis is based on the person's symptoms and often a biopsy.

  • There is no specific treatment, but doctors may give drugs to relieve symptoms.

There are many causes of panniculitis. Infections, cold temperatures, injury, systemic lupus erythematosus, disorders of the pancreas, inflammatory disorders (such as inflammatory bowel disease and polyarteritis nodosa), and alpha-1 antitrypsin deficiency. Erythema nodosum is a type of panniculitis.

Symptoms of Panniculitis

Panniculitis is characterized by tender, red skin bumps (nodules) that originate deep in the layer of fat beneath the skin (subcutaneous). They tend to be large, measuring several centimeters in diameter. The bumps are most common on the legs and arms and occur less often on the buttocks, trunk, and face.

People may have symptoms of general bodywide inflammation such as fever, joint and muscle pain, and feeling ill.

Diagnosis of Panniculitis

  • A doctor's evaluation

  • Often skin biopsy

Doctors base the diagnosis on the results of a physical examination.

The diagnosis of panniculitis is sometimes confirmed when doctors remove a bump or a small piece of one and then analyze it with a microscope (biopsy).

Treatment of Panniculitis

  • Anti-inflammatory drugs

  • Immunosuppressants

There is no specific treatment for panniculitis.

Doctors may give nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and inflammation. Other drugs that may help include drugs that are used for malaria; dapsone; or thalidomide.

Corticosteroids and other drugs that suppress the immune system (immunosuppressants) or chemotherapy drugs may be given to people whose symptoms are getting worse.

Any causes are also treated.

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