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- Title
Recurrent lipoatrophic panniculitis of children.
- Authors
Torrelo, A.; Noguera ‐ Morel, L.; Hernández ‐ Martín, A.; Clemente, D.; Barja, J.M.; Buzón, L.; Azorín, D.; Jesús, A.A.; López ‐ Robledillo, J.C.; Colmenero, I.; Kutzner, H.; Goldbach ‐ Mansky, R.; Requena, L.
- Abstract
Background Recurrent panniculitis in children with lipoatrophy has been loosely described and reported under different names, but has never been systematically evaluated by immunohistochemical stains. Objective To depict the profile of children with recurrent idiopathic panniculitis. Methods Study of clinical, histopathological and immunohistochemical features in five cases with recurrent idiopathic panniculitis. Results Five children with repeated attacks of painful subcutaneous nodules in association with fever, malaise and abdominal pain or arthralgia, with subsequent lipoatrophy were reviewed. In two patients, extensive involvement led to loss of the cutaneous fatty tissue. Laboratory abnormalities included increased acute phase reactants, leukocytosis with mild neutrophilia, microcytic anaemia and elevated liver enzymes. Histopathology showed lobar panniculitis without vasculitis and with a mixed infiltrate, composed of neutrophils, mononuclear cells, lymphocytes, macrophages and myeloid cells. Neutrophils and myeloid cells were more prominent in early lesions, whereas macrophages predominated in late stages, leading to lipophagia and lipoatrophy. Immunohistochemistry showed positive staining for myeloperoxidase around the necrotic adipocytes in early stages and CD68/PGM1 macrophages in late stages. Intense STAT1 staining was observed in the inflammatory infiltrate. All patients improved with methotrexate and corticosteroids. Conclusion We present five cases of lobar panniculitis and lipoatrophy in childhood. The clinico-pathologic presentation shares features with other autoinflammatory diseases.
- Subjects
IMMUNOSTAINING; CUTANEOUS manifestations of general diseases; ABDOMINAL pain; JOINT pain; NEUTROPHILS
- Publication
Journal of the European Academy of Dermatology & Venereology, 2017, Vol 31, Issue 3, p536
- ISSN
0926-9959
- Publication type
Article
- DOI
10.1111/jdv.13858