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Panniculitis

What is Panniculitis?

Inflammation of subcutaneous adipose tissue.

Questions and answers on "Panniculitis"

This is a follow up for Dr XXXXXXX XXXXXXX Kanodia. Thank you. I visited my vascular specialist today, & he said I have Panniculitis, not cellulitis. He says a vein removal would not be very helpful. I am to wear compression stockings on both legs, to walk, no standing & keep the legs up. No medications. Now what. What do I need to know, and what can I expect.There is still a scab. I would like an honest appraisal. Is this condition like to get worse, slowly get better, or appear on other parts of the body? I must say I have more energy that I have had fo a good 6 years.I am very, very grateful for your advice
Brief Answer:
Panniculitis is simple & recoverable condition

Detailed Answer:
Hello Madam,

Very good morning to you and thanks for showing confidence in me.

I beg your pardon for replying bit late as I was discussing your condition with my XXXXXXX colleagues. After a through discussion with them...
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I have a painful swollen areas under my left and right clavicles (left side swelling is much worse than right) and also there are painful lumps on the left side in my neck above the collar bone. The pain is almost unbearable, at times, and I feel so tired all the time. I was told I probably have panniculitis and I am being sent for a needle biopsy and ultrasound in a couple of days of the swelling and lumps under my left clavicle. I also get pain in my left breast and the recent mammogram and ultrasound suggested (by the breast surgeon) I have a fatty tumors in that breast. I have non alcoholic fatty liver disease and multiple subcutaneous lipomas. One lipoma in my abdomen is sore and looks like it is bruised. I also have unusual fat distribution. (see attached picture) I look like I work out with excess fat across my shoulders and chest with very little weight over my hips and thighs. I get frequent bouts of watery diarrhea, get tingling weakness in my hands and feet and bouts of mental dullness or confusion, including slurring of speech. I am a 55 year old female. I live in a remote area and I have to wait 6 months to see an Endocrinologist (low priority). Bloods show normal Thyroid levels but have picked up episodes of low blood cortisol 103 at 9:00 am (160 bottom of normal range - normal Synactyn response). 2 months ago I had two very large benign polyps removed from my uterus. I do not have diabetes . I am being brushed off as being menopausal. I feel it is more than just menopause. What do you think? Do you have any suggestions for me to give to my local family Dr. for tests etc?
Endocrinological evaluation for you would include work up for a few potential conditions. One is Cushing's disease or cortisol excess. The synacthen test you underwent is for the opposite condition ie deficiency of cortisol. Testing for cortisol excess can be done in a few ways. Options include a...
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I have had unexplained bruising on my legs and sometimes on my back. I have been tested for platelet and coagulation and both came back normal. Currently being treated for cellulitis and run a low grade fever. I have been diagnosed with Sarcoidosis and take leflunamide, humira and gabapentin. Stopped the leflunamide for a week and still bruised. Any other suggestions?
Hello and thanks for your query.

From the history it seems that you have been diagnosed with cellulitis, which is a state of inflammation of the skin and subcutaneous tissues due to trauma or infection. The most common cause of such infections are skin bacteria including streptococci and...
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My Wifes WIDAL report says
SLIDE METHOD - WIDAL
Salmonella typhi "O" 1 : 80
Salmonella typhi "H" 1 : 80
Salmonella paratyphi "A(H)" NON - REACTIVE
Salmonella paratyphi "B(H)" NON - REACTIVE
TYPHOID - IgM NEGATIVE

Is she suffering from typhoid. If yes what should be the course of the treatment. She had viral fever lat week 100-102, now she is not at all having any fever, however the WIDAL seems to be positive, she has throat infection and sinusitis at the moment and is taking Augmentin 625 along with antacid and vitamins. Is this treatment ok for Typhoid too?
Hi,
Thanks for using XXXXXXX

I have gone through available details and following are my comments:

1) This widal report is insignificant and titre is only 1:80, she has recently recovering from sinus and throat infection. Please continue antibiotics.

2) No treatment is required for Typhoid; just...
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Dear Sir,
I am 26 yrs old with frequent ulcers on my lower extremity of leg.I had ulcer for 4 times till date on my left leg.

First time (Oct 2008)--- It was small red rash turned into lesion with puss oozing out ( cured using antibiotics)-- no diagnosis made
Second time(Feb 2010)----this time i was treated with antibiotics and trental.( relieved)
Third time( feb 2011)----- a series of antibiotics, swab test ( IV antibiotics given) and skin biopsy done. Dx as erythema nodosum
Skin biopsy result:superfacial dermis shows fibrin deposition in the vessels and perivascular collection of macrophages,lymphocytes,neutrophils.At foci vasculitis changes in the forms of fibrinoid necrosis of vessel wall and presence of neutrophils noted.Deep dermis also show a focu of leucocytoclastic vasculitis


Fourth time( April 2013)-----rashes on leg with one lesion formed.
visited rheumatologist------- wrote skin biopsy again ( doctor thinks it can be PAN like vasculitis,Atrophie blanche,APLA syndrome)----biopsy yet to be done.

Past history:
Epileptic attack at age 14 ( only once and under medication for 8yrs)
Hypertension since 12yrs
operated for the ulcer in ileum at the age of 16 followed by Multiple sclerosis dx( with optic neuritis symptom within a span of 1 month from operation)
Sec attack of Optic neuritis after an yr( 2005)---difference between 2 attacks is 1 yr 8months.

Since then i have no issues till 2008 wherein i had ulcer on my left leg.

Sir my career n job involved long travel and continuous sitting job.Even just 2 days back.. i started developing small red bumps on my leg. I had joint pain with heat developed at joint in leg ankle. it vanished the very next 2 days. The very next day i have little cold liek symptoms with little soar throat.

I feel this ulcers can be due to Chronic venous insufficiency ( 80% of cases of Atrophie blanche is shown off as indication due to CVI , i read this in an article ). But the above old biopsy report says an indication of vasculitis. Is it worth relying on it? or another biopsy can be done involving medium sized artery. ( looking for the inflammation inside the artery)?

Please help me with this Sir.

Hi XXXXX,
Thanks for writing to us.
Firstly I would like to mention your skin biopsy does not corroborate with erythema nodosum. EN does not ulcerate and histopathologically( skin biopsy) it shows septal panniculitis without vasculitis ie inflammation of fat cells without inflammation of blood...
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During a CT scan in ER finding 8 mm kidney stone stuck in ureter and multiple smaller stones in each kidney, the radiologist found diffuse hepatic steatosis , misty mesentery with shotty nodes, mild stranding with lymphadenopathy r/o lymphoma . Repeat scan 2 months later found same finding, possible related to Mesenteric Paniculitis with lymphadenopathy. My enlarged kidney and the stone issue were resolved after I drank massive amounts of lemon juice, so the lithotripsy my urologist planned was cancelled the day before surgery after reading pre-op x-ray. My doctor ordered complete bloodwork which then flagged low platelets 117 (130-440), glucose 123 (74-106),BUN/Creat Ratio 18.6 (7-18.) a d low Vit D 13.5 (30.0-100.0). Then I was referred to a hemotologist/ oncologist who referred me to have a biopsy of lymph node. My symptoms: 169 lb female 58 years Changes in bowel habits, diarrhea often, walker s diarrhea , some tender areas in abdomen ( rt lower side and up on rt side closer to ribs), get very itchy on back side of head at times it sea to flare up especially in hot weather, hot flashes especially at night, stools have gotten skinner, looser. I m seeing a gastroenterologist next week and have scheduled an appt. w/ surgeon for biopsy, which I hope I don t need. The hematologist/oncologist said she doesn t think it is lymphoma, but she said some lymphomas can be obscure. She said a biopsy may show nothing, but suggested that as the next step. Overall, I feel good, but feel full and bloated a lot. I still have a strong appetite, but I m exercising and working hard to get my weight down. I ve had to deal w/lots is stress at work and the death of several family members in the past 7 years. A sibling had a carcinoid tumor that caused her great pain successfully removed several years ago and is doing well. Grandfather died of liver cancer, aunt died of multiple myeloma. Do you think I need to have a biopsy first or do a colonoscopy (just got notice I m due for it- 10 years since I was checked out due to anemia/very heavy menstrual periods at that time.) I ve been on synthroid and Benezepril for years.
Dear friend, welcome and thanks for entrusting your query here at Healthcaremagic!
I am Dr. Prasad Akole (Critical Care Expert- http://bit.ly/Dr-Prasad-Akole) and am glad to address to your query here.


Yes, it is not classical of lymphoma, but variants may occur.
Your combination of Fatty liver...
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I am 37 years old with Mesenteric Panniculitis. I have chronic abd pain. My medical hx includes Seizures (free for 12 years), H pylori (treated in 2008), ITP s/p splenectomy, cholecystectomy, recent dx of Hashimotos. My question regarding Mesenteric Panniculitis is if any research has shown gluten to be a factor. I have been tested negative for Celiacs but I am suspicious of being gluten intolerant as my pain worsens with gluten and the intensity lasts for weeks. If I do not eat gluten, the pain diminishes and the symptoms of the Mesenteric Panniculitis seem to lessen as well without ever truly going away. I am fearful of this progressing to a more fibroid situation leading to other complications and I just want to treat it and avoid any potential triggers for it if that is the case.
Hi,
Thanks for writing in.
Although there is no connection between mesentric panniculitis and gluten, there have been some case reports where this disease has been thought to originate from undiagnosed celiac disease. If that is the case, gluten restriction will help control the symptoms. Since...
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