J Korean Foot Ankle Soc.  2024 Mar;28(1):36-39. 10.14193/jkfas.2024.28.1.36.

Lupus Panniculitis of the Lower Leg Misdiagnosed as an Abscess: A Case Report

• Seo YC
• Lee HS
• Kim DY

• KMID: 2553808
• DOI: http://doi.org/10.14193/jkfas.2024.28.1.36

Abstract

Lupus panniculitis is a rare disease that may present with similar clinical manifestations to an infection, such as cellulitis or abscess. This paper reports a case of a 25-year-old woman with systemic lupus erythematosus who underwent surgical intervention initially with the suspicion of an abscess but who was eventually diagnosed with lupus panniculitis. Despite the low incidence of lower leg involvement of panniculitis, clinicians should be aware of the possibility of an etiology other than infection when encountering patients with inflammatory diseases. Moreover, a skin biopsy and magnetic resonance imaging with a diffusion-weight image may be helpful.

Keyword

Panniculitis, Systemic lupus erythematosus; Cellulitis; Abscess

Figure

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  Figure 1 Gross photograph of a 25-year-old woman with complaints of redness, swelling, and pain of the both lower leg. (A) Gross photograph taken at the first consultation. (B) Gross photograph taken at the second consultation, which was the 7 days after from the first consultation. Compared with last examination, 1 cm length open wound formation of the left lower leg is observed (marked by an arrow).

• 

  Figure 2 Preoperative magnetic resonance images of the left lower leg. Overall, heterogeneous high signals of the subcutaneous fat layer are observed in T2-weighted images of the both lower leg (marked by triangles). Those high signals are mixed with flake-like lesions. Furthermore, there are small amounts of fluid collections beneath the subcutaneous fat layer (marked by arrow). (A) T2-weighted axial view of the left lower leg. (B) T2-weighted coronal view of the left lower leg.

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  Figure 3 Intra-operative photographs. (A) When the lesion is squeezed, dark-blood colored fluid discharged from the open wound. (B) During the thorough debridement, multiple yellowish flakes were identified.

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