Document Detail

Lipoatrophic panniculitis: case report and review of the literature.
MedLine Citation:
PMID:  20713820     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Lipoatrophic panniculitis (LP) is a rare disease of childhood characterized by eruption of tender erythematous nodules and plaques followed by circumferential bands of lipoatrophy often seen on the arms and legs. This condition has also been known as lipophagic panniculitis of childhood, annular atrophy of the ankles, and partial lipodystrophy. OBSERVATIONS: A previously healthy 8-year-old boy was evaluated for tender, raised plaques on the ankles, which progressed to circumferential atrophy of the distal lower extremities. Biopsy specimen analysis revealed a dense mixed infiltrate extending into the subcutaneous tissue as well as lipophages within the fatty lobules. A diagnosis of LP was made, and the patient began treatment with prednisone and hydroxychloroquine. Methotrexate was added later to the regimen as a steroid-sparing agent, and the dose was increased over the course of 3 months, by which time the cutaneous disease progression was nearly halted. However, the patient continued to have lower leg pain with bone changes demonstrated on magnetic resonance imaging. CONCLUSIONS: We report this case and review of the literature to call attention to the clinical features of LP and its association with skeletal changes. Our patient's response to combination therapy is of interest and contributes to the limited literature about management of this disease.
Lisa Y Shen; M Bruce Edmonson; Gary P Williams; Chethana Chandrupatla Gottam; Molly A Hinshaw; Joyce M Teng
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Archives of dermatology     Volume:  146     ISSN:  1538-3652     ISO Abbreviation:  Arch Dermatol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-17     Completed Date:  2010-09-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372433     Medline TA:  Arch Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  877-81     Citation Subset:  AIM; IM    
Department of Dermatology, University of Wisconsin School of Medicine and Public Health, 1 S. Park Street, Madison, WI 53715, USA.
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MeSH Terms
Anti-Inflammatory Agents / therapeutic use
Antirheumatic Agents / therapeutic use
Drug Therapy, Combination
Hydroxychloroquine / therapeutic use
Lipodystrophy / diagnosis,  drug therapy,  physiopathology*
Magnetic Resonance Imaging*
Methotrexate / therapeutic use
Panniculitis / diagnosis,  drug therapy,  physiopathology*
Prednisone / therapeutic use
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Antirheumatic Agents; 118-42-3/Hydroxychloroquine; 53-03-2/Prednisone; 59-05-2/Methotrexate

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