Panniculitis - Pannikuliit
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References
Erythema nodosum is the most common form of panniculitis and is characterized by tender erythematous nodules mainly in the lower limbs on the pretibial area. The exact cause of erythema nodosum is unknown, although it appears to be a hypersensitivity response to a variety of antigenic stimuli. Although the etiology is mostly idiopathic, ruling out an underlying disease is imperative before diagnosing primary erythema nodosum. Erythema nodosum can be the first sign of a systemic disease that is triggered by a large group of processes, such as infections, inflammatory diseases, neoplasia, and/or drugs. The most common identifiable causes are streptococcal infections, primary tuberculosis, sarcoidosis, Behçet disease, inflammatory bowel disease, drugs, and pregnancy.
Panniculitis moodustavad heterogeense rühma põletikulisi haigusi, mis hõlmavad nahaalust rasvkude. Neid häireid esineb lastel harva. Pannikuliit võib olla süsteemse häire esmane protsess või sekundaarne protsess, mis tuleneb infektsioonist, traumast või ravimitega kokkupuutest. Enamikul pannikuliidi tüüpidel on sama kliiniline pilt (olenemata etioloogiast) , õrnade erütematoossete nahaaluste sõlmedega.
Panniculitides form a heterogenous group of inflammatory diseases that involve the subcutaneous adipose tissue. These disorders are rare in children and have many aetiologies. As in adults, the panniculitis can be the primary process in a systemic disorder or a secondary process that results from infection, trauma or exposure to medication. Some types of panniculitis are seen more commonly or exclusively in children, and several new entities have been described in recent years. Most types of panniculitis have the same clinical presentation (regardless of the aetiology), with tender, erythematous subcutaneous nodules.
Panniculitides form a heterogenous group of inflammatory diseases that involve the subcutaneous adipose tissue. These disorders are rare in children and have many aetiologies. As in adults, the panniculitis can be the primary process in a systemic disorder or a secondary process that results from infection, trauma or exposure to medication. Some types of panniculitis are seen more commonly or exclusively in children, and several new entities have been described in recent years. Most types of panniculitis have the same clinical presentation (regardless of the aetiology), with tender, erythematous subcutaneous nodules.
Panniculitis , nahaaluse rasvkoe põletik, avaldub tavaliselt põletikuliste sõlmedega. Erythema nodosum (EN) on kliiniliselt kõige sagedasem pannikuliidi vorm. Kuigi kuni 55% EN-st peetakse idiopaatiliseks, on kõige levinumad põhjused infektsioonid, ravimid, süsteemsed haigused, nagu sarkoidoos ja põletikuline soolehaigus, rasedus ja pahaloomulised kasvajad. EN esineb tavaliselt teismelistel ja 20ndatel ning sagedamini naistel. Sellele eelneb sageli ühe kuni kolme nädala pikkune mittespetsiifiline prodroom, mis võib hõlmata palavikku, halba enesetunnet ja ülemiste hingamisteede infektsiooni sümptomeid. Seejärel järgnevad nahakahjustused, mis paiknevad tavaliselt jäsemete sirutajakõõlusel. Kahjustused on valulikud ümarad või ovaalsed, kergelt tõusnud, mittehaavandilised punased sõlmed. EN täpset patogeneesi ei mõisteta, kuigi arvatakse, et see tuleneb immuunkomplekside ladestumisest vaheseinte veenidesse nahaaluses rasvas, põhjustades neutrofiilset pannikuliiti. Isegi ilma põhjusliku seisundi spetsiifilise ravita laheneb EN enamikul juhtudel ilma ravita.
Panniculitis, inflammation of the subcutaneous fat, usually presents with inflammatory nodules. Erythema nodosum (EN) is clinically the most frequent form of panniculitis. Whilst up to 55% of EN is considered idiopathic, the most common causes include infections, drugs, systemic illnesses such as sarcoidosis and inflammatory bowel disease, pregnancy, and malignancy. EN typically presents in the teens and 20s, and is seen more commonly in females. It is often preceded by a non-specific prodrome of one to three weeks, which may include fever, malaise, and symptoms of an upper respiratory tract infection. Cutaneous lesions then follow, typically localized on the extensor aspect of the limbs. The lesions are painful rounded or oval, slightly raised, non-ulcerative red nodules. The exact pathogenesis of EN is not understood, although is thought to result from deposition of immune complexes in the venules of the septae in subcutaneous fat, causing a neutrophilic panniculitis. Even without specific therapy for a causative condition, EN resolves without treatment in most cases.
Panniculitis, inflammation of the subcutaneous fat, usually presents with inflammatory nodules. Erythema nodosum (EN) is clinically the most frequent form of panniculitis. Whilst up to 55% of EN is considered idiopathic, the most common causes include infections, drugs, systemic illnesses such as sarcoidosis and inflammatory bowel disease, pregnancy, and malignancy. EN typically presents in the teens and 20s, and is seen more commonly in females. It is often preceded by a non-specific prodrome of one to three weeks, which may include fever, malaise, and symptoms of an upper respiratory tract infection. Cutaneous lesions then follow, typically localized on the extensor aspect of the limbs. The lesions are painful rounded or oval, slightly raised, non-ulcerative red nodules. The exact pathogenesis of EN is not understood, although is thought to result from deposition of immune complexes in the venules of the septae in subcutaneous fat, causing a neutrophilic panniculitis. Even without specific therapy for a causative condition, EN resolves without treatment in most cases.
"Nodoosne erüteem" on pannikuliit (panniculitis) vorm, mida iseloomustavad 1–10 cm suurused õrnad punased sõlmed, mis on seotud süsteemsete sümptomitega, sealhulgas palavik, halb enesetunne ja liigesevalu. Sõlmed võivad taanduda 2–6 nädala jooksul ilma haavanditeta või armistumiseta. Nodoosset erüteemi seostatakse infektsioonidega, sealhulgas C-hepatiit, EBV ja tuberkuloos, rasedus, mitte-Hodgkini lümfoom ja pankrease vähk.