Panniculitis - 脂膜炎
结核病是重要原因之一。
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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 形成一组涉及皮下脂肪组织的异质炎症性疾病。这些疾病在儿童中很少见。脂膜炎可以是全身性疾病的主要过程，也可以是由感染、创伤或接触药物引起的继发过程。大多数类型的脂膜炎具有相同的临床表现（无论病因如何），具有触痛的红斑皮下结节。
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（皮下脂肪炎症）通常表现为炎性结节。Erythema nodosum (EN) 是临床上最常见的脂膜炎形式。虽然高达55%的EN被认为是特发性的，但最常见的诱因包括感染、药物、系统性疾病（如结节病和炎症性肠病）、妊娠以及恶性肿瘤。EN 多见于青少年和约20岁的年轻人，女性发病率更高。发病前常有一至三周的非特异性前驱症状，如发热、不适和上呼吸道感染表现。随后出现皮肤损害，通常位于四肢伸肌侧。病灶为疼痛的圆形或椭圆形、轻度隆起、无溃疡的红色结节。EN 的确切发病机制尚不明确，但被认为是免疫复合物沉积于皮下脂肪间隔的微静脉，引发中性粒细胞性脂膜炎。即使不针对病因进行特殊治疗，大多数EN患者也可自行痊愈，无需额外治疗。
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.
“结节性红斑”是脂膜炎 (Panniculitis) 的一种形式，表现为直径 1–10 厘米的触痛性红色结节，并伴有发热、不适和关节疼痛等全身症状。结节通常在 2–6 周内自行消退，不会留下溃疡或瘢痕。结节性红斑常与感染有关，如丙型肝炎、EBV、结核病；亦可见于妊娠、非霍奇金淋巴瘤和胰腺癌等情况。