Panniculitis - Panikulitas
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ReferencesErythema 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 sudaro heterogeninę uždegiminių ligų grupę, apimančią poodinį riebalinį audinį. Vaikams šie sutrikimai yra reti. Panikulitas gali būti pagrindinis sisteminio sutrikimo procesas arba antrinis procesas, atsirandantis dėl infekcijos, traumos ar vaistų poveikio. Daugumos panikulito tipų klinikinis vaizdas yra toks pat (nepriklausomai nuo etiologijos) , su jautriais, eriteminiais poodiniais mazgeliais.
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, poodinių riebalų uždegimas, dažniausiai pasireiškia uždegiminiais mazgeliais. Erythema nodosum (EN) yra kliniškai dažniausia panniculito forma. Nors iki 55 % EN laikomi idiopatiniais, dažniausiai pasitaikančios priežastys yra infekcijos, vaistai, sisteminės ligos (pvz., sarkoidozė, uždegiminė žarnyno liga), nėštumas ir piktybiniai navikai. EN paprastai pasireiškia paaugliams ir 20‑metų amžiaus žmonėms, dažniau moterims. Prieš tai dažnai būna nespecifinis, trukęs nuo vienos iki trijų savaičių, prodromas, kuris gali apimti karščiavimą, bendrą silpnumą ir viršutinių kvėpavimo takų infekcijos simptomus. Tada atsiranda odos pažeidimai, paprastai lokalizuoti galūnių tiesiamojoje dalyje. Pažeidimai yra skausmingi, suapvalinti arba ovalūs, šiek tiek iškilę, neopini raudoni mazgeliai. Tiksli EN patogenezė nėra suprantama, nors manoma, kad ji atsiranda dėl imuninių kompleksų nusėdimo poodinių riebalų pertvarų venulėse, sukeliant neutrofilinį panniculitą. Net ir nesant specifinės priežastinės būklės gydymo, EN daugeliu atvejų išnyksta savaime.
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.
Mazginis eritemas yra panikulito (panniculitis) forma, kuriai būdingi jautrūs raudoni 1–10 cm mazgeliai, susiję su sisteminiais simptomais, įskaitant karščiavimą, silpnumą ir sąnarių skausmą. Mazgeliai gali išnykti per 2–6 savaites be opų ar randų. Mazginis eritemas siejamas su infekcijomis, įskaitant hepatitą C, EBV ir tuberkuliozę, nėštumu, ne Hodgkin's limfoma ir kasos vėžiu.