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Subcutaneous Fat

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Atlas of Dermatology, Dermatopathology and Venereology

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Abstract

Inflammatory diseases of the subcutaneous fat are common causes of diagnostic difficulties as different types of panniculitis can overlap in their clinical and histological presentation. Whenever a panniculitis is suspected, a specimen from a deep incisional biopsy and adequate clinical correlation are essential to reach a definitive diagnosis. It is also important to consider that subcutaneous fat may also be secondarily involved from deep cutaneous infections, metastatic tumors, radiotherapy, and vasculitis.

In this chapter, in addition to the different types of panniculitis, lipodystrophy on an etiological basis is discussed.

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References

  • Ackerman AB, Guo Y, Vitale PA (1991) Clues to diagnosis in dermatopathology. ASCP Press, Chicago

    Google Scholar 

  • Bielsa I, Ariza A (2007) Deep morphea. Semin Cutan Med Surg 26(2):90–95

    Article  CAS  PubMed  Google Scholar 

  • Bolotin D, Duffy KL, Petronic-Rosic V, Rhee CJ, Myers PJ, Stein SL (2011) Cold panniculitis following ice therapy for cardiac arrhythmia. Pediatr Dermatol 28(2):192–194

    Article  PubMed  Google Scholar 

  • Briki H, Bouaziz JD, Molinier-Frenkel V, Delfau-Larue MH, Ortonne N, Bagot M (2010) Subcutaneous panniculitis-like T-cell lymphoma αβ: complete sustained remission with corticosteroids and methotrexate. Br J Dermatol 163(5):1136–1138

    Article  CAS  PubMed  Google Scholar 

  • Campbell LB, Miller OF 3rd (2006) Intralesional triamcinolone in the management of lipodermatosclerosis. J Am Acad Dermatol 55(1):166–168

    Article  PubMed  Google Scholar 

  • Campos LM, Miot LDB, Marques MEA, Miot HA (2019) Case for diagnosis. Noninfectious suppurative panniculitis induced by mesotherapy with deoxycholate. An Bras Dermatol 94(6):754–756

    Article  PubMed  PubMed Central  Google Scholar 

  • Cerroni L (2014) Subcutaneous panniculitis-like T-cell lymphoma. In: Skin lymphoma: the illustrated guide, 4th edn. Wiley

    Chapter  Google Scholar 

  • Cortés VA, Fernández-Galilea M (2015) Lipodystrophies: adipose tissue disorders with severe metabolic implications. J Physiol Biochem 71(3):471–478

    Article  PubMed  CAS  Google Scholar 

  • Cusack CA, Fanelli M (2014) Panniculitis. In: Lebwohl M, Heymann W, Berth-Jones J, Coulson I (eds) Treatment of skin disease, 4th edn. Elsevier Saunders, London, p 526

    Google Scholar 

  • Delgado-Jimenez Y, Fraga J, García-Díez A (2008) Infective panniculitis. Dermatol Clin 26(4):471–480

    Article  PubMed  Google Scholar 

  • Diamantis S, Bastek T, Groben P, Morrell D (2006) Subcutaneous fat necrosis in a newborn following ice bag application for treatment of supraventricular tachycardia. J Perinatol 26(8):518–520

    Article  CAS  PubMed  Google Scholar 

  • Esfandiari HN, Rubenfire M, Neidert HA, Hench R, Jalal Eldin A, Meral R, Oral EA (2019) Diagnosis of acquired generalized lipodystrophy in a single patient with T-cell lymphoma and no exposure to Metreleptin. Clin Diabetes Endocrinol 5:4

    Article  PubMed  PubMed Central  Google Scholar 

  • Fett N, Werth VP (2011) Update on morphea: part I. epidemiology, clinical presentation, and pathogenesis. J Am Acad Dermatol 64(2):217–228

    Article  PubMed  Google Scholar 

  • Frumholtz L, Roux J, Bagot M, Rybojad M, Bouaziz J (2016) Treatment of generalized deep morphea with everolimus. JAMA Dermatol 152(10):1170–1172

    Article  PubMed  Google Scholar 

  • García-Porrúa C, González-Gay MA, Vázquez-Caruncho M, López-Lazaro L, Lueiro M, Fernández ML, Alvarez-Ferreira J, Pujol RM (2000) Erythema nodosum: etiologic and predictive factors in a defined population. Arthritis Rheum 43(3):584–592

    Article  PubMed  Google Scholar 

  • García-Romero D, Vanaclocha F (2008) Pancreatic panniculitis. Dermatol Clin 26(4):465–470

    Article  PubMed  Google Scholar 

  • Garg A (2004) Acquired and inherited lipodystrophies. N Engl J Med 350(12):1220–1234

    Article  CAS  PubMed  Google Scholar 

  • Garg A (2011) Lipodystrophies: genetic and acquired body fat disorders. J Clin Endocrinol Metab 96(11):3313–3325

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gilchrist H, Patterson JW (2010) Erythema nodosum and erythema induratum (nodular vasculitis): diagnosis and management. Dermatol Ther 23(4):320–327

    Article  PubMed  Google Scholar 

  • Hanauer SB (1998) How do I treat erythema nodosum, aphthous ulcerations, and pyoderma gangrenosum? Inflamm Bowel Dis 4(1):70

    Article  CAS  PubMed  Google Scholar 

  • Hansen CB, Callen JP (2010) Connective tissue panniculitis: lupus panniculitis, dermatomyositis, morphea/scleroderma. Dermatol Ther 23(4):341–349

    Article  PubMed  Google Scholar 

  • Herouy Y (2000) Lipodermatosclerosis and compression stockings. J Am Acad Dermatol 42(2 Pt 1):307–308

    Article  CAS  PubMed  Google Scholar 

  • Hussain I, Garg A (2016) Lipodystrophy syndromes. Endocrinol Metab Clin N Am 45(4):783–797

    Article  Google Scholar 

  • Kamath S, Vaccaro SA, Rea TH, Ochoa MT (2014) Recognizing and managing the immunologic reactions in leprosy. J Am Acad Dermatol 71(4):795–803

    Article  PubMed  Google Scholar 

  • Karkouche R, Bernigaud C, Fontugne J, Zehou O, Bellaud G, N’Diaye M, Cherif K, Wolkenstein P, Chosidow O, Ortonne N, Ingen-Housz-Oro S (2017) Cold-associated perniosis of the thighs histopathologically mimicking lupus. Six obervations. J Eur Acad Venereol 31(6):1029–1032

    Article  CAS  Google Scholar 

  • Krawiec P, Melges B, Pac-Kozuchowska E, Mroczkowska-Juchkiewicz A, Czerska K (2016) Fitting the pieces of the puzzle together: a case report of the Dunnigan-type familial partial lipodystrophy in the adolescent girl. BMC Pediatr 16:38

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Lyon MJ (2010) Metabolic panniculitis: alpha-1 antitrypsin deficiency panniculitis and pancreatic panniculitis. Dermatol Ther 23(4):368–374

    Article  PubMed  Google Scholar 

  • Miteva M, Romanelli P, Kirsner RS (2010) Lipodermatosclerosis. Dermatol Ther 23(4):375–388

    Article  PubMed  Google Scholar 

  • Montenegro Junior RM, Paiva Lima GEC, Oliveira Fernandes V, Rangel Montenegro APD, Melo Ponte CM, Vasconcelos Martins L, Pascoalino Pinheiro D, Amaral de Moraes ME, Odorico de Moraes M, Brasil d’Alva C (2020) Leu124Serfs*26, a novel AGPAT2 mutation in congenital generalized lipodystrophy with early cardiovascular complications. Diabetol Metab Syndr 12:28

    Article  PubMed  PubMed Central  Google Scholar 

  • Morrison LK, Rapini R, Willison CB, Tyring S (2010) Infection and panniculitis. Dermatol Ther 23(4):328–340

    Article  PubMed  Google Scholar 

  • Mowla MR, Ara S, Mizanur Rahman AFM, Tripura SP, Paul S (2017) Leprosy reactions in postelimination stage: the Bangladesh experience. J Eur Acad Dermatol Venereol 31(4):705–711

    Article  CAS  PubMed  Google Scholar 

  • Ng PP, Tan SH, Tan T (2002) Lupus erythematous panniculitis: a clinicopathological study. Int J Dermatol 41(8):488–490

    Article  PubMed  Google Scholar 

  • Oliveira J, Freitas P, Lau E, Carvalho D (2016) Barraquer-Simons syndrome: a rare form of acquired lipodystrophy. BMC Res Notes 9:175

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Patterson JW (2012) Panniculitis. In: Bolognia JL, Schaffer JV, Cerroni L (eds) Dermatology, 3rd edn. Elsevier Saunders, Philadelphia, p 1641

    Google Scholar 

  • Pekki A, Sauni R, Vaalasti A, Toivio P, Huotari-Orava R, Hasan T (2011) Cold panniculitis in Finnish horse riders. Acta Derm Venereol 91(4):463–464

    Article  PubMed  Google Scholar 

  • Pope E, Janson A, Khambalia A, Feldman B (2006) Childhood acquired lipodystrophy: a retrospective study. J Am Acad Dermatol 55(6):947–950

    Article  PubMed  Google Scholar 

  • Requena L, Sánchez Yus E (2001) Panniculitis. Part II. Mostly lobular panniculitis. J Am Acad Dermatol 45(3):325–361

    Article  CAS  PubMed  Google Scholar 

  • Requena L, Yus ES (2001) Panniculitis. Part I. mostly septal panniculitis. J Am Acad Dermatol 45(2):163–183

    Article  CAS  PubMed  Google Scholar 

  • Sabroe RA, Wallington TB, Kennedy CT (1995) Dermatomyositis treated with high-dose intravenous immunoglobulins and associated with panniculitis. Clin Exp Dermatol 20(2):164–167

    Article  CAS  PubMed  Google Scholar 

  • Saenz IB, Meeker J, Jalali O, Lynch MC (2018) Cold-induced dermatosis: case report and review of the literatures. Am J Dermatopathol 40(4):291–294

    Article  Google Scholar 

  • Santucci M, Pimpinelli N, Massi D, Kadin ME, Meijer CJ, Müller-Hermelink HK, Paulli M, Wechsler J, Willemze R, Audring H, Bernengo MG, Cerroni L, Chimenti S, Chott A, Díaz-Pérez JL, Dippel E, Duncan LM, Feller AC, Geerts ML, Hallermann C, Kempf W, Russell-Jones R, Sander C, Berti E (2003) Cytotoxic natural killer cell cutaneous lymphomas: report of the EORTC cutaneous lymphoma task force workshop. Cancer 97(3):610–627

    Article  PubMed  Google Scholar 

  • Segal S, Cooper J, Bolognia J (2000) Treatment of lipodermatosclerosis with oxandrolone in a patient with stanozolol-induced hepatotoxicity. J Am Acad Dermatol 43(3):558–559

    Article  CAS  PubMed  Google Scholar 

  • Snow JL, Su WPD (1996) Lipomembranous (membranocystic) fat necrosis: clinicopathologic correlation of 38 cases. Am J Dermatopathol 18(2):151–155

    Article  CAS  PubMed  Google Scholar 

  • Soulard R, Souraud JB, Landais C, Le Hemon A, Gaillard T, Fouet B (2010) Histopathology of a granulomatous lobular panniculitis in acute Q fever: a case report. J Cutan Pathol 37(8):870–876

    Article  CAS  PubMed  Google Scholar 

  • Sterling JB, Heymann WR (2000) Potassium iodide in dermatology: a 19th centrury drug for the 21st century-uses, pharmacology, adverse effects, and contraindications. J Am Acad Dermatol 43(4):691–697

    Article  CAS  PubMed  Google Scholar 

  • Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman JW (2008) Subcutaneous panniculitis- like T-cell lymphoma. In: WHO classification of tumours of haematopoietic and lymphoid tissues. IARC Press, Lyon, pp 294–295

    Google Scholar 

  • Taj FT, Vyshak BM (2019) Acquired partial lipodystrophy: Barraquer –Simons syndrome: a rare case report. Our Dermatol Online 10(1):59–61

    Article  Google Scholar 

  • Thurber S, Kohler S (2006) Histopathologic spectrum of erythema nodosum. J Cutan Pathol 33(1):18–26

    Article  PubMed  Google Scholar 

  • Tsukamoto Y, Katsunobu Y, Omura Y, Maeda I, Hirai M, Teshima H, Konishi Y, Inoue T, Sato T (2006) Subcutaneous panniculitis-like T-cell lymphoma: successful initial treatment with prednisolone and cyclosporin a. Intern Med 45(1):21–24

    Article  PubMed  Google Scholar 

  • Valverde R, Rosales B, Ortiz-de-Frutos FJ, Rodríguez-Peralto JL, Ortiz-Romero PL (2008) Alpha-1-antitrypsin deficiency panniculitis. Dermatol Clin 26(4):447–451

    Article  CAS  PubMed  Google Scholar 

  • Vantyghem MC, Balavoine AS, Douillard C, Defrance F, Dieudonne L, Mouton F, Lemaire C, Bertrand-Escouflaire N, Bourdelle-Hego MF, Devemy F, Evrard A, Gheerbrand D, Girardot C, Gumuche S, Hober C, Topolinski H, Lamblin B, Mycinski B, Ryndak A, Karrouz W, Duvivier E, Merlen E, Cortet C, Weill J, Lacroix D, Wémeau JL (2012) How to diagnose a lipodystrophy syndrome. Ann Endocrinol (Paris) 73(3):170–189

    Article  CAS  Google Scholar 

  • Vesić S, Vuković J, Medenica LJ, Pavlović MD (2008) Acute lipodermatosclerosis: an open clinical trial of stanozol in patients unable to sustain compression therapy. Dermatol Online J 14(2):1

    PubMed  Google Scholar 

  • Walker SL, Balagon M, Darlong J, Doni SN, Hagge DA, Halwai V, John A, Lambert SM, Maghanoy A, Nery JA, Neupane KD, Nicholls PG, Pai VV, Parajuli P, Sales AM, Sarno E, Shah M, Tsegaye D, Lockwood DN (2015) ENLIST 1: an international multicentre cross-sectional study of the clinical features of erythema nodosum leprosum. PLoS Negl Trop Dis 9(9):e0004065

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Walsh SN, Santa Cruz DJ (2010) Lipodermatosclerosis: a clinicopathological study of 25 cases. J Am Acad Dermatol 62(6):1005–1012

    Article  PubMed  Google Scholar 

  • Willemze R, Jansen PM, Cerroni L, Berti E, Santucci M, Assaf C, Canninga-van Dijk MR, Carlotti A, Geerts ML, Hahtola S, Hummel M, Jeskanen L, Kempf W, Massone C, Ortiz-Romero PL, Paulli M, Petrella T, Ranki A, Peralto JL, Robson A, Senff NJ, Vermeer MH, Wechsler J, Whittaker S, Meijer CJ (2008) Subcutaneous panniculitis-like T-cell lymphoma: definition, classification, and prognostic factors: an EORTC cutaneous lymphoma group study of 83 cases. Blood 111(2):838–845

    Article  CAS  PubMed  Google Scholar 

  • Winkelmann RK (1983) Panniculitis in connective tissue disease. Arch Dermatol 119(4):336–344

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Dermatology, Champalimaud Clinical Center, Lisbon, Portugal

    Virgínia Coelho de Sousa

  2. Department of Dermatology, Hospital de Santo António dos Capuchos, Centro Hospitalar de Lisboa Central, Lisbon, Portugal

    Ana Brasileiro, Ana Sofia Borges & Rita Pinheiro

  3. Centro Académico de Medicina, Faculdade de Medicina, University of Lisbon, Lisbon, Portugal

    André Oliveira

Authors
  1. Virgínia Coelho de Sousa
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  2. Ana Brasileiro
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  3. Ana Sofia Borges
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  4. Rita Pinheiro
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  5. André Oliveira
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Editor information

Editors and Affiliations

  1. Department of Pathology, Univ of Rochester School of Med, Rochester, NY, USA

    Bruce Smoller

  2. Khorramshahr, Iran

    Nooshin Bagherani

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de Sousa, V.C., Brasileiro, A., Borges, A.S., Pinheiro, R., Oliveira, A. (2021). Subcutaneous Fat. In: Smoller, B., Bagherani, N. (eds) Atlas of Dermatology, Dermatopathology and Venereology . Springer, Cham. https://doi.org/10.1007/978-3-319-45134-3_42-1

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  • DOI: https://doi.org/10.1007/978-3-319-45134-3_42-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-45134-3

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