RESUMO
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.
Assuntos
Ácido Desoxicólico/efeitos adversos , Mesoterapia/efeitos adversos , Paniculite Nodular não Supurativa/induzido quimicamente , Paniculite Nodular não Supurativa/patologia , Adulto , Biópsia , Derme/patologia , Feminino , Humanos , Paniculite Nodular não Supurativa/tratamento farmacológico , Resultado do TratamentoRESUMO
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.
Assuntos
Humanos , Feminino , Adulto , Paniculite Nodular não Supurativa/induzido quimicamente , Paniculite Nodular não Supurativa/patologia , Ácido Desoxicólico/efeitos adversos , Mesoterapia/efeitos adversos , Biópsia , Paniculite Nodular não Supurativa/tratamento farmacológico , Resultado do Tratamento , Derme/patologiaRESUMO
The clinical signs of chronic nodular panniculitis in a three-year-old mare were consistent with a diagnosis of sterile nodular panniculitis, but the mare had histopathological signs of both generalised steatitis and sterile nodular panniculitis. The mare was deficient in vitamin E and selenium.
Assuntos
Doenças dos Cavalos/patologia , Paniculite Nodular não Supurativa/veterinária , Animais , Doença Crônica , Dexametasona/uso terapêutico , Feminino , Doenças dos Cavalos/diagnóstico por imagem , Cavalos , Paniculite Nodular não Supurativa/diagnóstico por imagem , Paniculite Nodular não Supurativa/patologia , Selênio/deficiência , Ultrassonografia , Deficiência de Vitamina E/complicações , Deficiência de Vitamina E/veterináriaRESUMO
Infection with Borrelia burgdorferi can induce various skin manifestations. The type of skin manifestation and the histopathological picture depend on the stage of infection and vary from local inflammatory infiltrates to chronic atrophic skin disease. Involvement of subcutaneous tissue has been observed only very rarely. We report on two patients suffering from nodular panniculitis (Pfeifer-Weber-Christian) and present evidence that the disease was caused by Borrelia burgdorferi. In one of the cases Borrelia burgdorferi was repeatedly isolated from skin and subcutaneous tissue biopsies in spite of repeated high-dose therapy with ceftriaxone, Doxycycline and cefotaxime.
Assuntos
Doença de Lyme/diagnóstico , Paniculite Nodular não Supurativa/diagnóstico , Adulto , Idoso , Biópsia , Grupo Borrelia Burgdorferi/isolamento & purificação , Cefotaxima/administração & dosagem , Diagnóstico Diferencial , Doxiciclina/administração & dosagem , Esquema de Medicação , Quimioterapia Combinada/uso terapêutico , Humanos , Doença de Lyme/tratamento farmacológico , Doença de Lyme/patologia , Masculino , Paniculite Nodular não Supurativa/tratamento farmacológico , Paniculite Nodular não Supurativa/patologia , Pele/patologiaRESUMO
Eighteen cases of mesenteric panniculitis of the colon collected from the literature, together with two cases from the authors' source, were reviewed. The disease occurred most often in late adult life, with a male predominance. Symptoms were abdominal pain, diarrhea, constipation, and a lower abdominal mass in most patients. Barium enema disclosed narrowing, shortening, and poor extensibility of the colon, and ultrasonography and computed tomography showed thickening of the mesocolon and colonic wall with soft-tissue density. Exploratory laparotomy was done in all patients, and colectomy, colostomy, or other surgical treatments were performed in 17 (85 percent). Gross appearance at the time of surgery was characterized by a marked thickening or a firm mass of the mesocolon with a puckered surface involving the appendices epiploicae of the colon. Microscopically, degeneration of the adipose tissue, revealed by aggregates of lipid-laden macrophages, was diagnostic. Inflammatory infiltration and fibrosis also were present in many patients. Mesenteric panniculitis of the colon seems to be a lesion more advanced than the same condition of the small intestine, and colostomy or bypass surgery may be needed for alleviation of severe symptoms.