Some patients who have been treated with corticosteroids will develop a transient form of panniculitis.


Patients affected: most often children


Clinical features:

(1) history of recent (days or weeks) rapid discontinuation of systemic corticosteroid therapy

(2) development of asymptomatic subcutaneous nodules measuring up to 4 cm in diameter

(3) lesions are commonly found on the cheeks, torso and arms

(4) lesions resolve either spontaneously or after steroid therapy is restarted


Histologic findings:

(1) lobular inflammation with lymphocytes, histiocytes and foreign body type giant cells

(2) focal areas of necrosis are often present

(3) needle-like clefts within lipocyte (probably formed by dissolving triglyceride crystals during tissue processing)

(4) absence of vascular and septal inflammation


Differential diagnosis:

(1) panniculitis due to the underlying disease being treated with the corticosteroids

(2) subcutaneous fat necrosis of the newborn


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