Panniculitis is an inflammation of adipose tissue, often subcutaneous, but sometimes localized elsewhere in the body, including the surrounding internal organs. The inflammatory process covers fatty lobules or interlobular septa.

Both adults and children are ill, women more often than men.

Panniculitis is more common in the extremities, but may also affect the trunk Causes and risk factors The mechanism of the disease is unknown. Causal factors can be:.

infections (streptococcal infection is the main cause of erythema nodosum, a form of panniculitis);

systemic diseases (systemic sclerosis, vasculitis, systemic lupus erythematosus);

intestinal inflammatory diseases;

intoxication;

sarcoidosis;

histiocytosis;

lymphoproliferative diseases;

alpha-1-antitrypsin deficiency;

pancreatic pathologies characterized by excessive activity of pancreatic enzymes;

injuries (including operating ones), hypothermia.

Forms of the disease Depending on the origin, the following forms of pathology are distinguished: infectious, enzymatic, traumatic, autoimmune, etc.. When the cause cannot be identified, panniculitis is called idiopathic..

One of the most common forms of the disease is idiopathic lobular (nodular) panniculitis, which is called Weber-Christian disease.. Synonyms: febrile recurrent non-suppressing panniculitis, chronic recurrent Weber-Christian panniculitis.

There are also nodal form (erythema nodosum), plaque, infiltrative, visceral (internal), mixed. One of the rare forms is mesenteric panniculitis - a chronic nonspecific inflammation of the adipose tissue of the mesentery of the intestine, omentum and peritoneal tissue.

Symptoms Panniculitis is manifested by the formation of subcutaneous erythematous nodes up to 5 cm in diameter, characterized by intense pain. They are usually located on the lower extremities, but can occur on the buttocks, back, abdomen, buttocks, chest and face. Less commonly, in the scrotum, lungs, abdomen (mesenteric panniculitis), and skull.

The symptoms of different forms of panniculitis have some differences..

The form.

Manifestations.

Plaque.

Separate nodules merge into plaques covered with purple or bluish skin. Plaques can be extensive, covering the entire surface of the limb. Against their background, lymphostasis often develops due to compression of blood vessels and nerve endings.

Infiltrative.

In the area of \u200b\u200bthe nodes, the subcutaneous fat melts, fistulas are formed, from which pus-like contents come out, which, unlike pus, are sterile, i.e.. does not contain infectious agents.

Mixed.

The transition from one form to another is characteristic - it begins with a nodular, which transforms into a plaque, and then into an infiltrative.

The main symptom of Weber-Christian disease is the nodes located in the subcutaneous fatty tissue, usually located in the region of the extremities, less often on the trunk. The appearance of nodules is preceded by musculoskeletal pain and an increase in temperature to subfebrile values \u200b\u200b(no higher than 38 ° C). The nodules are sharply painful, the skin above them is changed, sharply hyperemic or purple-cyanotic. They are observed for several weeks, after which they heal, leaving behind rounded scars.. Sometimes the nodes break through with the release of a yellowish oily discharge (infiltrative form), which subsequently also leads to scarring. Inflammation can be widespread, involving joints, liver, kidneys, serous membranes, bone marrow.

The disease often develops against the background of diseases of the pancreas. A triad of lesions is characteristic: panniculitis, arthritis, pancreatitis.

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