J Korean Rheum Assoc.  2008 Mar;15(1):76-80. 10.4078/jkra.2008.15.1.76.

Lobular Panniculitis in a Patient with Dermatomyositis

• Kim YJ
• Uhm WS
• Kim TH
• Lee CW
• Park CK
• Jun JB

• KMID: 1324513
• DOI: http://doi.org/10.4078/jkra.2008.15.1.76

Abstract

Panniculitis is an inflammation within adipose tissue and most commonly affects the subcutaneous fat. Frequently, the panniculitis is associated with certain drugs and systemic diseases, such as various rheumatologic diseases, idiopathic Weber-Christian disease, infection and malignancy. Panniculitis in dermatomyositis (DM) is most commonly an incidental histopathologic finding that less commonly manifests a clinical component. We report the case of a woman with DM who presented with panniculitis as a clinical finding. A 51-year-old woman was admitted to our hospital with diffuse nodular, indurated, painful erythematous plaques on buttocks, back and chest. 18-months ago, she had been diagnosed DM at our hospital. Her medication on admission was azathioprine. High-dose glucocorticoid was prescribed after the diagnosis of lobular panniculitis confirmed by skin biopsy. After then, the patient was getting better and discharged with the medication tapered.

Keyword

Lobular panniculitis; Dermatomyositis

MeSH Terms

Female
Humans
Biopsy

Figure

• 

  Fig. 1. Initial skin findings were diffuse nodular, indurated, painful erythematous plaques with multifocal lipoatrophy on buttocks, back (A) and chest (B).

• 

  Fig. 2. The skin biopsy shows lymphocytes infiltration in the subcutaneous fat lobule (H&E ×400).

• 

  Fig. 3. After high dose steroid and azathioprine treatment, diffuse erythematous multiple plaques on buttocks, back (A) and chest (B) were decreased.

Reference

References

1. Eberhard BA, Ilowite NT. Panniculitis and lipodystrophy. Curr Opin Rheumatol. 2002; 14:566–70.

2. Ter Poorten MC, Thiers BH. Panniculitis. Dermatol Clin. 2002; 20:421–33.

3. Diaz Cascajo C, Borghi S, Weyers W. Panniculitis: definition of terms and diagnostic strategy. Am J Dermatopathol. 2000; 22:530–49.

4. Chao YY, Yang LJ. Dermatomyositis presenting as panniculitis. Int J Dermatol. 2000; 39:141–4.

5. Solans R, Cortes J, Selva A, Garcia-Patos V, Jimenez FJ, Pascual C, et al. Panniculitis: a cutaneous manifestation of dermatomyositis. J Am Acad Dermatol. 2002; 46:S148–50.

6. Ghali FE, Reed AM, Groben PA, McCauliffe DP. Panniculitis in juvenile dermatomyositis. Pediatr Dermatol. 1999; 16:270–2.

7. Janis JF, Winkelmann RK. Histopathology of the skin in dermatomyositis. A histopathologic study of 55 cases. Arch Dermatol. 1968; 97:640–50.

8. Neidenbach PJ, Sahn EE, Helton J. Panniculitis in juvenile dermatomyositis. J Am Acad Dermatol. 1995; 33:305–7.

9. Molnar K, Kemeny L, Korom I, Dobozy A. Panniculitis in dermatomyositis: report of two cases. Br J Dermatol. 1998; 139:161–3.