PANCREATIC PANNICULITIS

By Gary M. White, MD


A panniculitis mimicking erythema nodosum may occur in association with pancreatic disease, most commonly pancreatitis secondary to alcoholism. It may also occur secondary to pancreatic cancer.

Clinical

An acute eruption of tender erythematous nodules on the shins and legs in a patient with pancreatic disease. Lesions may ulcerate, discharging an oily brown liquid (liquefied fat?). Fat of the body may be affected, leading to systemic signs and symptoms, e.g., arthritis, pleural effusion.

Schmid's triad--a poor prognostic sign--is panniculitis, polyarthritis, and eosinophilia in a patient with pancreatic cancer.

Differential Diagnosis

Workup usually includes biopsy, culture of any draining liquid, and pancreatic enzymes. See panniculitis differential.

Treatment

Any pancreatic disease should be treated. The skin lesions may be more easily tolerated if rest, elevation, and pain medication are prescribed. As the pancreatitis improves, so should the skin lesions.

References

A 61-year-old woman presented with 3 occasions over 2 months of multiple tender erythematous nodules on both lower limbs extending to the thighs. Biopsy was consistent with pancreatic panniculitis which was then found on further workup. JAAD Case Rep. 2016 May; 2(3): 244–246

CMAJ February 7, 2012 vol. 184 no. 2 E159

RegionalDerm

Homepage | FAQs | Contact Dr. White


It is not the intention of RegionalDerm.com to provide specific medical advice, diagnosis or treatment. RegionalDerm.com only intends to provide users with information regarding various medical conditions for educational purposes and will not provide specific medical advice. Information on RegionalDerm.com is not intended as a substitute for seeking medical treatment and you should always seek the advice of a qualified healthcare provider for diagnosis and for answers to your individual questions. Information contained on RegionalDerm.com should never cause you to disregard professional medical advice or delay seeking treatment. If you live in the United States and believe you are having a medical emergency call 911 immediately.