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Neutrophilic Panniculitis

Panniculitis is a condition that causes inflammation in the third layer of skin, also known as the subcutaneous layer. According to "Dermatopathology: A Volume in the Foundations in Diagnostic Pathology," Neutrophilic panniculitis is a rare lobular form of the disease that affects about one in every 7,000 people. Panniculitis does not always manifest itself in the same way, and multiple forms can be present in a single patient.

  1. Location

    • The third layer of the skin tissue contains the main blood vessels and nerves, and is largely responsible for the body’s ability to regulate its temperature. It is largely composed of fat cells and connective tissues. Different forms of panniculitis affect either the lobules (fat cells) or the septae (connective tissue). In cases of Neutrophilic panniculitis, inflammation primarily occurs in the fat tissue itself.

    Causes

    • Panniculitis occurs when some other condition is present, which makes a patient more susceptible to the inflammation. Neutrophilic panniculitis is commonly associated with both rheumatoid arthritis and myleodysplasia. Myleodysplasia was once called pre-leukemia and is characterized by irregular or inefficient bone marrow. It can also be caused by trauma to the surrounding tissues and exposure to cold. Pancreatic conditions, lupus and lymphoma could be other causes.

    Symptoms

    • This condition presents itself in a nodular eruption. This swelling may cause the skin to look red, and it may be painful to the touch. Affected skin may also become extremely hard and woody, or rough textured and lacking sensation. Nodes may also open and leak a clear, oily substance or pus. The inflammation of an affected node will usually subside over the course of a few weeks. When this happens, a depressed area or discolored tissue may remain. If the condition persists without improvement, more serious complications can occur, including liver failure, bleeding, heart damage and pancreatic complications.

    Diagnosis

    • A skin biopsy is used to check for panniculitis. When it is diagnosed it then becomes important to find the root cause of the condition. The tests used to diagnose the underlying condition vary widely, depending on other symptoms present in the patient.

    Treatment

    • The most effective known treatment for Neutrophilic panniculitis is oral steroids, which may be given in combination with anti-inflammatory drugs. This will coincide with treatment of the underlying condition which is causing the panniculitis. A more aggressive treatment includes a combined dosage of chemotherapy and cyclophosphamide.

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