Panniculitis is a disease that leads to destructive changes in the fatty subcutaneous tissue. The most dangerous form of panniculitis is visceral, with the development of this form, the fatty tissues of the internal organs are affected.
The content of the article:
Forms of panniculitis:
Causes of panniculitis
Symptoms of panniculitis
Diagnosis of panniculitis
Treatment of panniculitis
Panniculitis
There is a primary and secondary form of panniculitis. The primary form of the disease begins without any predisposing factors, that is, without a cause. This form is most often manifested in women under forty who are overweight.
The secondary form of the disease has its own classification and occurs for a number of reasons.
Forms of panniculitis:
There are also several forms of panniculitis, it depends on the type of skin lesions. There is a plaque, nodular and infiltrative form of fatty granuloma.
Knotty shape
The knotty shape is manifested by the appearance of nodes with a diameter from a couple of millimeters to a couple of centimeters. This form acquires either a pinkish or bluish hue, depending on the depth of the location. Nodes do not merge with each other.
Plaque
The plaque form occurs as a result of the fusion of nodes, such formations occupy large areas on the surface of the skin of the lower leg or thigh. It is also possible to note the swelling of the limb. The color of the affected skin has a bumpy surface and a blue color.
Infiltrative form
The infiltrative form is characterized by fluctuation on the nodules and a bright red color. Upon autopsy, a yellow substance is found, resembling foam in consistency.
Causes of panniculitis
immunological panniculitis develops on the basis of systemic vasculitis;
enzymatic panniculitis occurs against the background of the action of enzymes produced by the pancreas and appears with pancreatitis;
polypherative cell panniculitis appears in patients with leukemia or lymphoma;
lupus or lupus is a panniculitis form that occurs with lupus disease, their symptoms are almost the same;
the cold form develops during hypothermia, characterized by the appearance of dense nodules. It is often found in children and adolescents, occurs within a few days after hypothermia. Foci are localized on the cheeks and chin. Women who are engaged in horse riding also suffer from this disease, while areas of the hips and pelvis suffer. This form of panniculitis does not require special treatment, but it is recommended to use protective equipment against hypothermia;
the crystalline form develops with renal insufficiency or gout. It is characterized by deposits of urates and calcifications in subcutaneous tissue;
artificial fat granuloma occurs at the injection site when various drugs and liquids are administered. This form is observed in people with mental disabilities who inject various substances under their skin. Measures are taken based on the fluid that has been injected into the subcutaneous tissue;
the steroid form occurs in children as a reaction to steroid drugs. Special treatment is not carried out, recovery occurs immediately after the withdrawal of drugs;
the hereditary form develops with a lack of a substance called antiprypsin.
Symptoms of panniculitis
Panniculitis is manifested by nodular formations. It is localized mainly on the legs, arms or stomach. After the nodes of panniculitis are cured, skin cavities remain in their places.
In the case of a nodular form of panniculitis, separately located nodes with a red tint appear on the surface in the subcutaneous tissue.
The plaque form of panniculitis is characterized by the presence of nodes that, fusing together, form a bumpy area. The skin color of such formations varies from pink to purple—blue shade. Such areas sometimes occupy the entire area of the shin or shoulder, while squeezing vessels and nerve bundles, thus bringing painful sensations and swelling.
The infiltrative form proceeds with the decay of nodes, then in the area of the node of a blue hue, fluctuation appears. When opening such nodes, a yellow thick liquid resembling a purulent substance is released, but it is not pus.
It is also possible to transition from the nodular form of panniculitis to the plaque form and then to the infiltrative form.
With spontaneous infection with panniculitis, changes in subcutaneous fat are observed, which may not be accompanied by failures in the general state of the body. But most often, at the initial stage of the disease, such symptoms appear, for example, weakness or headache, and an increase in body temperature is also observed.
Panniculitis can have an acute, subacute or recurrent form of development. The development time ranges from two or three weeks to two years.
The acute form of panniculitis is manifested by high fever and pain in the joints and muscles, impaired kidney and liver function. During treatment, the patient’s condition still continuously worsens and within a year ends in death.
The subacute condition of the patient is more gentle, but there is a violation of liver functions and is accompanied by fever.
The most sparing condition of panniculitis is recurrent or chronic. Relapses of the disease are severe, the general condition of the patient does not change, but this period is replaced by a long period of remission.
Diagnosis of panniculitis
Panniculitis is diagnosed at an appointment with a dermatologist, and a rheumatologist and a nephrologist, also a gastroenterologist, helps him in making a diagnosis. A biochemical analysis of urine and blood is prescribed. With the help of ultrasound, the abdominal cavity, kidneys and liver, pancreas are examined to identify nodes of visceral panniculitis. A blood test for sterility helps to exclude the septic nature of the disease. Bacteriological examination of the yellow contents, which is released when the node is opened, helps to distinguish the infiltrative variant of panniculitis from an abscess.
The exact analysis of panniculitis is determined by a node biopsy. Histological examination determines inflammatory infiltration, replacement of fat cells by connective tissue. An immunological study diagnoses lupus panniculitis.
Treatment of panniculitis
Treatment of panniculitis takes into account etiopathogenetic factors. In the acute course of panniculitis, which is accompanied by fever, pain in muscles and joints, changes in blood composition, bed rest and benzylpenicillin are prescribed. In severe form of paniculitis, the drug prednisolone is used. With immunological forms of panniculitis, treatment with antimalarial drugs begins.
A number of vitamins are also used, such as A, E, C, R. The treatment regimen for panniculitis is selected depending on the course and form of the disease. Also, the treatment should be comprehensive.
The chronic form of nodular panniculitis is treated with anti-inflammatory drugs, a complex of vitamins. Also, the nodes are pricked with drugs that contain glucocorticosteroids.
Plaque and infiltrative form is treated with glucocorticosteroids and cytostatics. Hepatoprotectors help the liver function. Also, physiotherapy is carried out in any form.
Quite often, along with treatment with medications, folk remedies are also used. Herbal ingredients are used, for example, compresses from raw beetroot on the affected areas of the skin, compresses from mashed hawthorn fruits, and lotions from crushed plantain leaves. Such compresses relieve swelling and have an anti-inflammatory effect. It is good and healthy for the body to drink herbal teas based on echinacea and rosehip.
Relapses of panniculitis are often associated with intercurrent infections, therefore, during this period, the supervision of a dermatologist and a therapist will be required.
There is practically no prevention for this disease, since it does not have a clear scheme for the development of primary panniculitis. But for the second form of the development of panniculitis, the treatment of the underlying disease is carried out.
The chronic form and the subacute form have favorable prognoses for recovery, unlike the acute form, which is unpredictable.
