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skin_nodules

skin nodular "rash"

Introduction

  • when discussing “nodular rashes” this is generally referring to “panniculitis” (inflammation of the subcutaneous tissue)
  • superficial skin nodules are a separate diagnostic entity

Panniculitis

  • inflammation of the subcutaneous tissue
  • diagnosis can be confusing as many clinically look similar with features of:
    • deep induration
    • swelling of skin
    • erythema, warmth, tenderness
    • possible ulceration of overlying skin
  • any diagnostic biopsy needs to include the subcutaneous tissue via either:
    • incisional biopsy
    • double punch biopsy technique (2nd punch is in same spot and provides access to subcutaneous layer)

DDx of mainly upper body or trunk panniculitis

  • lupus profundus
  • pancreatic
  • alpha-1 antitrypsin deficiency
  • cold panniculitis
  • infection induced

DDx of lower leg panniculitis

  • erythema nodosum (ant. shins esp.)
  • erythema induratum
  • esp. post. lower legs and may ulcerate
  • occas. assoc with tuberculosis (TB) or as reaction to drugs or infections
  • usually has septal vasculitis and is of a lobular pattern
  • dermatomyositis
  • lipodermaosclerosis (mainly medial, just above ankles)
  • traumatic panniculitis
  • subcutaneous panniculitis like T cell lymphoma
skin_nodules.txt · Last modified: 2023/11/29 05:09 by gary1

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