ABSTRACT
Abstract A 28-year-old white female patient presented with multiple erythematous-to-violaceous, painful, suppurative nodules on the buttocks and thighs that appeared after two weeks of mesotherapy with deoxycholate, caffeine, sunflower liposomes, and sinetrol for localized fat. She was treated for atypical mycobacteriosis, but with no satisfactory response after antibiotic therapy. Bacterial, mycobacterial, and fungal culture were all negative. Histopathologic examination of the biopsy showed noninfectious suppurative panniculitis. It resolved after treatment with methotrexate, prednisone, and hydroxychloroquine. This report highlights the rarity of this complication, the importance of its early recognition, and differentiation with atypical fast growing mycobacterioses.
Subject(s)
Humans , Female , Adult , Panniculitis, Nodular Nonsuppurative/chemically induced , Panniculitis, Nodular Nonsuppurative/pathology , Deoxycholic Acid/adverse effects , Mesotherapy/adverse effects , Biopsy , Panniculitis, Nodular Nonsuppurative/drug therapy , Treatment Outcome , Dermis/pathologyABSTRACT
Weber-Christian disease (WCD) is a rare inflammatory disease of adipose tissue, which is characterized by painful cutaneous nodules and constitutional symptoms. Although any area of the body containing fat can be affected by WCD, the involvement of retrobulbar fat is uncommon and proptosis is a rare presenting manifestation. We report a case who presented with proptosis of the right eye which is accompanied by painful subcutaneous nodules, high fever and myalgia. Biopsies of retrobulbar tissue and suprapubic nodule showed lobular panniculitis with mixed cellular infiltration, mainly composed of histiocytes and lymphocytes. He responded well to high-dose glucocorticoid.
Subject(s)
Adult , Humans , Male , Biopsy , Exophthalmos/pathology , Exophthalmos/etiology , Exophthalmos/drug therapy , Glucocorticoids/administration & dosage , Magnetic Resonance Imaging , Panniculitis, Nodular Nonsuppurative/pathology , Panniculitis, Nodular Nonsuppurative/drug therapy , Panniculitis, Nodular Nonsuppurative/complicationsABSTRACT
Weber-Christian disease (WCD) is a rare inflammatory disease of adipose tissue, which is characterized by painful cutaneous nodules and constitutional symptoms. Although any area of the body containing fat can be affected by WCD, the involvement of retrobulbar fat is uncommon and proptosis is a rare presenting manifestation. We report a case who presented with proptosis of the right eye which is accompanied by painful subcutaneous nodules, high fever and myalgia. Biopsies of retrobulbar tissue and suprapubic nodule showed lobular panniculitis with mixed cellular infiltration, mainly composed of histiocytes and lymphocytes. He responded well to high-dose glucocorticoid.
Subject(s)
Adult , Humans , Male , Biopsy , Exophthalmos/pathology , Exophthalmos/etiology , Exophthalmos/drug therapy , Glucocorticoids/administration & dosage , Magnetic Resonance Imaging , Panniculitis, Nodular Nonsuppurative/pathology , Panniculitis, Nodular Nonsuppurative/drug therapy , Panniculitis, Nodular Nonsuppurative/complicationsABSTRACT
Se presenta el primer reporte en Uruguay de un caso de Paniculitis nodular no supurativa, o síndrome de Weber Christian. Esta es una enfermedad rara más aún en niños, y su etiología es desconocida. Esta se caracteriza clínicamente por nódulos subcutáneos, fiebre, repercusión general y manifestaciones sistémicas, sobre todo a nivel hepático, pulmonar y digestivo. Su diagnóstico es de sospecha clínica y confirmación anatomopatológica, con la biopsia de piel que evidencia una paniculitis lobulillar no supurativa característica. Se acompaña en ocasiones de alteraciones de la inmunidad celular. El tratamiento con corticoides es de relativo éxito, siendo el pronóstico incierto
Subject(s)
Humans , Male , Infant , Panniculitis, Nodular Nonsuppurative , Uruguay , Panniculitis, Nodular Nonsuppurative/diagnosis , Panniculitis, Nodular Nonsuppurative/pathology , Panniculitis, Nodular Nonsuppurative/therapyABSTRACT
Un niño de 14 meses de edad ingresó por presentar placa indurada en la piel del muslo izquierdo y fiebre alta de un mes de evolución. Durante su hospitalización aparecieron nódulos subcutáneos sensibles con características inflamatorias en cara y tronco, adenopatías cervicales y hepatomegalia. En la biopsia de la piel había extensa destrucción del tejido celular subcutáneo, células espumosas, vasculitis e infiltración por leucocitos polimorfonucleares; en la de ganglio linfático se comprobó proliferación histiocitaria y en una muestra de hígado obtenida por punción se encontró evidencia de esteatosis. Se descartaron osteoartritis, celulitis, septicemia, tuberculosis, enfermedad del colágeno y neoplasia linforreticular. Recibió tratamiento con prednisona con excelente respuesta. Se ha mantenido asintomático a lo largo de 12 meses de seguimiento
Subject(s)
Panniculitis, Nodular Nonsuppurative/pathology , Biopsy , Diagnosis, Differential , Panniculitis, Nodular Nonsuppurative/drug therapy , Prednisone/therapeutic useSubject(s)
Adult , Female , Antibodies, Antinuclear/immunology , Lupus Erythematosus, Systemic/immunology , Panniculitis, Nodular Nonsuppurative/complications , Autoantibodies , Fluorescent Antibody Technique , Lupus Erythematosus, Systemic/complications , Panniculitis, Nodular Nonsuppurative/pathologyABSTRACT
El material histológico de 50 pacientes con diferentes formas de paniculitis nodular en los miembros inferiores, ha sido estudiado con el método de microscopía de fluorescencia utilizando los fluorocromos auramina 00 y rodamina B, así como el método de Ziehl-Neelsen en busca de bacterias acidoresistentes. Los resultados obtenidos con el método de microscopía de fluorescencia, que tiene grandes ventajas en comparación con el método de Ziehl-Neelsen, demuestran que en algunos casos de paniculitis nodular (en un 12%) y especialmente en casos con eritema indurado (en un 16.7%), se encuentran bacterias acidoresistentes que probablemente corresponden al grupo de las micobacterias de la especie M. tuberculosis.