Abstract
Pancreatic panniculitis is a form of subcutaneous fat necrosis that occurs as a rare manifestation of various pancreatic diseases, most commonly pancreatitis, or pancreatic carcinoma. Fat necrosis at remote sites occurs in only a small percentage of those with pancreatic disease. Its pathogenesis is uncertain. A review of 893 hospital admissions for various pancreatic diseases revealed only three cases of pancreatic panniculitis (1). Circulating pancreatic enzymes, lipase and amylase, are elevated in most but not all cases of pancreatic panniculitis (2). Human pancreatic lipase has been identified in lesions of pancreatic panniculitis, supporting its role in the pathogenesis of the disease (3). In vitro and clinical observations suggest that factors other than circulating amylase and lipase are necessary for the development of pancreatic panniculitis. In vitro incubation of human adipose tissue with pancreatic enzymes and serum from a patient with pancreatic panniculitis and elevated enzymes failed to induce fat necrosis, suggesting that there are other local factors or a labile circulating factor needed to induce the necrosis (4).
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References
Mullin GT, Ceperton EM, Crespin SR, et al. Arthritis and skin lesions resembling erythema nodosum in pancreatic disease. Ann Intern Med 1968; 68: 75–87.
Schrier RW, Melmon KL, Fenster LF. Subcutaneous nodular fat necrosis in pancreatitis. Arch Intern Med 1965; 116: 832–836.
Dhawan SS, Jiminez-Acosta F, Poppiti RJ, Barkin JS. Subcutaneous fat necrosis associated with pancreatitis: Histochemical and electron microscopic findings. Am J Gastroent 1990; 85: 1025–1028.
Berman B, Conteas C, Smith B, Leong S, Hornbeck L. Fatal pancreatitis presenting with subcutaneous fat necrosis: Evidence that lipase and amylase alone do not induce lipocyte necrosis. J Am Acad Dermatol 1987; 17: 359–364.
Cutlan RT, Wesche WA, Jenkins JJ, Chesney TM. A fatal case of pancreatic panniculitis presenting in a young patient with systemic lupus. J Cutan Pathol 2000; 27: 466–471.
Levine N, Lazarus G. Subcutaneous fat necrosis after paracentesis. Arch Dermatol 1976; 112: 993–994.
Thompson LDR, Heffess CS. Pancreas. In: Mills SE, Carter D, Greenson JK, Oberman HA, Reuter V, Stoler MH, eds. Sternberg’s Diagnostic Surgical Pathology, 4th ed. Philadelphia: Lippincott Williams and Wilkins, 2004, 1623–1625.
Sibrack LA, Gouterman IH. Cutaneous manifestations of pancreatic diseases. Cutis 1978; 21: 763–768.
Haber RM, Assaad DM. Panniculitis associated with a pancreas divisum. J Am Acad Dermatol 1986; 14: 331–334.
Hughes PSH, Apisarnthanarax P, Mullins JF. Subcutaneous fat necrosis associated with pancreatic disease. Arch Dermatol 1975; 111: 506–510.
Potts DE, Mass MF, Iseman MD. Syndrome of pancreatic disease, subcutaneous fat necrosis and polyserositis. Am J Med 1975; 58: 417–423.
Good AE, Schnitzer B, Kawanishi H, Demetropoulos C, Rapp R. Acinar pancreatic tumor with metastatic fat necrosis: Report of a case and review of rheumatic manifestations. Digestive Dis 1976; 21: 978–987.
Szymanski FJ, Bluefarb SM. Nodular fat necrosis and pancreatic diseases. Arch Dermatol 1961; 83: 224–229.
Ball NJ, Adams SPA, Marx LH, Enta T. Possible origin of pancreatic fat necrosis as a septal panniculitis. J Am Acad Dermatol 1996; 34: 362–364.
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(2007). Pancreatic Panniculitis. In: Deadly Dermatologic Diseases. Springer, New York, NY. https://doi.org/10.1007/978-0-387-68858-9_21
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DOI: https://doi.org/10.1007/978-0-387-68858-9_21
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