Panniculitis
Description:
Panniculitis - a limited or widespread inflammation of a fatty tissue, first of all hypodermic.
Panniculitis symptoms:
The panniculitis enzymatic is caused by influence of pancreatic enzymes, is characterized by painful nodes with a necrosis of subcutaneous fat. It can be combined with arthritises, a pleural exudate, ascites, etc.
Systemic lesions sometimes lead to death.
The diagnosis of a panniculitis is established on the basis:
* data of a histologic research (signs of a fatty necrosis)
* increases in level of activity of amylase and a lipase in skin and urine.
The panniculitis caused by deficit of alfa1-antitrypsin quite often has hereditary character and is followed by emphysema of lungs, hepatitis, cirrhosis, a vasculitis, a small tortoiseshell.
The panniculitis immunological quite often develops on the basis of various vasculites. Rotman-Maka the syndrome (a lipogranulomatosis hypodermic) quite often is option of a current of a deep knotty erythema at children, characterized by existence of violent nodes, fevers.
The differential diagnosis is carried out with a spontaneous panniculitis of Weber-Krischena, a knotty vasculitis, a knotty and indurative erythema.
The panniculitis lupoid (a lupus erythematosus deep, a lyupus-panniculitis) is characterized by deep hypodermic nodes or plaques, quite often painful and ulcerated, located in the field of proximal departments of extremities, a trunk, buttocks, sometimes the heads and necks.
Skin over the defeat centers is usually not changed, but can be hyperemic, poykilodermichny or have signs of a diskoidny lupus erythematosus.
The current is long, after regress of rashes there is an atrophy of skin or a lipoatrophia.
Histologically in hypodermic cellulose - a picture of a diffusion lobulyarny panniculitis.
At a direct immunoflgoorestsention deposits of IgG and With, in a zone of a basal membrane of epidermis often come to light
Differentiate with a spontaneous panniculitis.
Treatment: synthetic antimalarial drugs. At widespread rashes - corticosteroids inside, and in the absence of effect - a cytostatics.
The panniculitis proliferative and cellular develops at lymphoma, leukemia, a histiocytosis, etc.
The panniculitis cold is result of the localized changes after impact of cold on any body part.
Developed at children at mouth corners more often (at suction of icicles).
It is clinically characterized by dense nodes of pink color with indistinct borders (Perfigeration).
Subjectively the cryesthesia and pain disturb.
Nodes persistirut during 2-3 weeks and are resolved completely.
The panniculitis artificial develops from administration of various drugs (for example, at the Paraffinoma).
The panniculitis steroid is observed at children in 1-14 days after the termination of the general corticosteroid therapy.
It is shown by pruritic hypodermic nodes with a diameter from 0,5 to 4 cm which coloring varies from color of normal skin to red.
Rashes are localized on cheeks, upper extremities, a trunk.
Treatment is not required as there comes spontaneous treatment.
The panniculitis crystal is caused by adjournment of microcalcificats at a hypercalcemia against the background of a renal failure, urates at gout, crystals after injections of some medicines (менеридин, pentazocine), cholesterol from atheromatous plaques at an embolism.
Panniculitis eosinophilic - manifestation of nonspecific reaction at a number of skin and general diseases:
* knotty erythema,
* skin vasculites,
* stings of insects,
* injection lipofatichesky granuloma,
* eosinophilic cellulitis,
* system lymphoma.
Panniculitis spontaneous Weber-Krischena (a panniculitis the knotty not suppurating in the fever recurrent) - the most frequent form of a panniculitis.
Strikes young women more often.
In a pathogeny of a spontaneous panniculitis the important part is assigned to strengthening of process of peroxide oxidation of lipids.
It is clinically shown by the single or multiple hypodermic nodes which are located more often in extremities and buttocks, is more rare - on a breast, a stomach, a pubis, cheeks.
At a knotty version nodes are accurately delimited from surrounding fabric, their coloring depending on a depth of nodes varies from color of normal skin to bright pink, and diameter fluctuates from several millimeters to 10 cm and more.
The Blyashechny version is result of merge of separate nodes in a plotnoelastichesky hilly conglomerate; skin color over it varies from pink to cyanotic-crimson.
The infiltrative version is characterized by emergence of fluctuation in a zone of separate nodes or conglomerates and bright red or crimson color; opening of the center happens to allocation of yellow foamy weight.
At the system course of a disease in pathological process the hypodermic fatty tissue of retroperitoneal area, an epiploon, a fatty tissue of a liver, a pancreas and other bodies are involved that can lead to a lethal outcome.
Current of a spontaneous panniculitis long, recurrent.
The disease proceeds from a week to several years.
Separate elements regress spontaneously then there is a pigmentation or a hem.
The forecast depends on a form of a course of a disease (chronic, subacute, acute).
Knotty panniculitis
Panniculitis reasons:
Process is connected with fermentopatiya, immune disturbances, external Cold and traumatic influences. The panniculitis can be a skin syndrome of some general diseases (a lupus erythematosus, a sarcoidosis, etc.).
Treatment of the Panniculitis:
Treatment at accurate communication from focal or general infections provides prescription of antibiotics of a wide range. At an acute current in hard cases apply glucocorticoids, Prednisolonum to 60 — 80 mg a day is more often. In chronic option basic therapy is shown by delagil or plaquenil. Topical treatment includes: applications of 33% of solution of Dimexidum, occlusive bandages with corticosteroid ointments, Voltarenum-emulgelem, butadiene ointment.
