Eosinophilic panniculitis

We report a case of eosinophilic meningitis associated with the ingestion of raw fish (Cichla sp.) from the Brazilian Amazon, likely caused by Gnathostoma. A 36-year-old male visited Juruena river on a fishing trip. After 50 days, the patient presented with an intense frontal headache. A cerebrospinal fluid examination revealed 63% eosinophilia. Another individual who ingested raw fish developed linear dermatitis on the abdominal wall. Anti-Gnathostoma serum antibodies were detected, and the patient made a full recovery after treatment with corticosteroids and albendazole...

A young male presented with intermittent high-grade fever, asymmetric polyarthritis and erythematous, tender nodules over left shin for 2 months duration. He had a history of alcohol dependence with multiple episodes of acute pancreatitis. With polyarthritis progressing relentlessly, unresponsive to non-steroidal anti-inflammatory drugs and steroids, a provisional diagnosis of sarcoidosis was considered. Indeed, he was treated with azathioprine and rituximab with no effect. Biopsy of the skin nodule revealed subcutaneous fat necrosis, foam cells, deposition of eosinophilic amorphous material and calcification...

BACKGROUND: Pancreatic panniculitis is a rare form of panniculitis generally associated with acute or chronic pancreatitis, and less frequently with pancreatic carcinoma. Clinically, it presents with subcutaneous nodules usually located in the lower extremities, however, it presents an almost pathognomonic histopathological finding with enzymatic fat necrosis in the adipose tissue. METHODS: In this retrospective case series of five hospitals, biopsy specimens of cutaneous lesions of pancreatic panniculitis were reviewed...

Paraneoplastic syndromes in rheumatology are a group of canonical rare rheumatic diseases with musculoskeletal involvement that occur in close temporal and causal association with malignancies. Knowledge of these possibly enables a prognostically relevant early diagnosis of the underlying malignant disease. In the era of immune checkpoint inhibitor treatment, there are first indications of an increase in the incidence and severity of paraneoplastic syndromes, so that they are becoming of increasing importance for the practicing rheumatologist...

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Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare form of low-grade cutaneous lymphoma that usually presents with multifocal non-tender subcutaneous nodules over the trunk and extremities. We present an exceptional case of SPTCL masquerading as a solitary abscess which developed following an antecedent arthropod bite. Unique histological features encountered include foci of neutrophilic aggregation and admixed eosinophils within the neoplastic lymphomatous subcuticular infiltrate. As SPTCL rarely presents as an abscess, the authors wish to highlight this diagnostic pitfall and suggest excluding SPTCL as a cause of pseudo-pyoderma in patients who are afebrile with a discordant inflammatory marker profile...

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BACKGROUND: Erythema nodosum (EN) is the most common panniculitis associated with a wide variety of conditions. Updated studies regarding the clinicopathological manifestations related to etiologies of EN and its prognosis are limited. OBJECTIVE: We aimed to explore the clinicopathological features in relation to the etiologies of EN and determine characteristics of disease recurrence and its predictive factors. METHODS: A total of 169 patients with biopsy-proven EN or septal panniculitis from January 2008 to September 2018 were retrospectively reviewed...

Palisading granulomatous dermatitis and panniculitis is recognized in various cutaneous inflammatory lesions secondary to presumed collagen damage. Cutaneous nodules with a palisading arrangement of histiocytes surrounding foci of collagen degeneration have been clinically termed palisading granuloma in dogs. Study aims were to characterize the cellular infiltrate of canine palisading granuloma and document salient clinical features. Inclusion criteria were met for 36 dogs and encompassed nodular dermal and subcutaneous histiocyte-predominant cellular infiltrates targeting and enveloping collagen fibers/necrotic foci with palisading configurations...

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Exenatide extended-release was recently developed as an antidiabetic drug; it acts as a glucagon-like peptide-1 receptor agonist. A 54-year-old male visited our clinic complaining of a subcutaneous tender nodule on his left thigh that had developed over the course of 1 week. The patient had received exenatide extended-release injections for 5 months to treat diabetes. A histopathologic examination showed septal and lobular panniculitis with lymphohistiocyte and eosinophil infiltration. The patient was diagnosed with eosinophilic panniculitis (EP) due to exenatide extended-release injection...

We present a 57-year-old female with a past medical history of rheumatoid arthritis, hypertension, and hypothyroidism who presented with poorly demarcated, nonblanching, painful, erythematous nodules on the bilateral lower legs for two weeks. The patient recently switched from infliximab to abatacept infusions, and skin eruptions presented 53 days from her initial abatacept infusion. A 5 mm punch biopsy of the left anterior upper leg in the zone of involvement showed a deep dermal granulomatous infiltrate with associated eosinophils and a vaguely horizontally palisaded pattern with necrobiosis...

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare subtype of cutaneous T-cell lymphoma. There may be a significant histologic overlap with traumatic panniculitis and lupus profundus. We describe a 54-year-old woman who had received a diagnosis of SPTCL based upon a left parietal scalp biopsy 5 years earlier. This diagnosis was supported by immunohistochemistry (IHC) demonstrating a CD8+ predominant lymphocyte population in the subcutis. T-cell gene rearrangement studies were not performed at that time...

Skin findings are common among patients with hematological malignancies and are thought to be expressions of a reactive spectrum peculiar to immunosuppressed patients with an unclear pathogenesis. Eosinophilic panniculitis is a reaction pattern defined by single or multiple lesions consisting in nodules and plaques, and sometimes in papules and pustules, characteristically associated to hematological neoplasms or to a series of benign conditions such as arthropod bites. We report a case of eosinophilic panniculitis occurring in a 77-year-old woman with chronic lymphocytic leukemia...

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A 38-year-old woman presented to the emergency department with a history of thoracic pain and anorexia for 1 week. Thoracic CT scan showed bilateral pleural effusion, a thoracentesis was performed revealing a transudate liquid with polymorphonuclears and predominance of eosinophils. After admission, the patient developed abdominal pain and the abdominal CT scan showed densification of the mesenteric fat characteristic of mesenteric panniculitis (MP). The patient went through investigation for secondary causes of panniculitis including infection, neoplasia and autoimmune diseases, and no abnormalities were found...

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Lipoatrophic panniculitis (LP) is a rare childhood panniculitis characterized by sclerotic, atrophic plaques on the extremities. We present a case of LP diagnosed during the inflammatory phase that was difficult to distinguish clinically from eosinophilic fasciitis. This report adds to the limited phenotypic spectrum of LP by differentiating the clinical features of disease activity from disease damage and highlighting the importance of biopsy in establishing a diagnosis.

A 28-year-old man presented with a sudden onset of left leg pain and swelling. There was no history of preceding trauma. Initial blood tests were unremarkable, ultrasound imaging showed extensive subcutaneous oedema. He then developed similar symptoms in his right leg, followed by both arms, and finally his forehead. A fluctuating peripheral eosinophilia subsequently developed. Biopsies of the arm and forehead showed an evolving panniculitis. The clinical features, peripheral eosinophilia, imaging and histology were consistent with a diagnosis of eosinophilic fasciitis...

Gnathostomiasis is an emerging disease in non-endemic countries. This zoonotic nematode requires aquatic freshwater environments to complete its life cycle where larvae get encrusted in fishes. Typically, the infection manifests as migratory subcutaneous lesion caused by the larvae trak, which produces an eosinophilic panniculitis. Here we describe a patient who presented a migratory lesion with no response to antimicrobial therapy, a careful travel and food history together with specific laboratory tests led to the correct diagnosis...