Panniculitis Review for the Inpatient Dermatologist

Purposeof ReviewPanniculitis presents a diagnostic challenge due to the diverse array of conditions that manifest with a similar clinical picture. Often, these diseases have ties to systemic issues and can be clues to underlying systemic ailments. This article reviews panniculitides pertinent to the inpatient setting, with focus on distinguishing features and approach to diagnosis and management.Recent FindingsErythema nodosum that presents with vasculitis and/or is atypically distributed may serve as a diagnostic clue for underlying systemic disease. Panniculitis may be the presenting sign of alpha-1 antitrypsin deficiency, particularly in patients homozygous for the Pi*Z genotype. Empiric tuberculosis therapy is not recommended in all cases of erythema induratum. Panniculitis may be the presenting feature or sole symptom of pancreatic disease and may signal metastasis in cases associated with pancreatic carcinoma. Genetic susceptibility has been implicated in polyarteritis nodosa.SummaryThe differential diagnosis for classifying panniculitis and for identifying underlying cause is broad. Inpatient dermatologists have an important role in diagnosing panniculitides and in deciphering overall health implications.