Panniculitis is a progressive process of inflammation of the subcutaneous tissue, which destroys fat cells, they are replaced by connective tissue, nodes, infiltrates and plaques form. With the visceral type of the disease, fat cells of the kidneys, liver, pancreas, adipose tissue or the area behind the peritoneum are affected. In approximately 50% of cases, the pathology takes an idiopathic form, which is mainly observed in women 20-50 years old. The other 50% is secondary panniculitis, which develops against the background of systemic and skin diseases, immunological disorders, the influence of various provoking factors (cold, some medications). The basis of the formation of panniculitis is a defect in lipid peroxidation.
Reasons for the appearance
Such inflammation of the subcutaneous tissue can be caused by various bacteria (mainly staphylococci and streptococci). In most cases, its development occurs on the lower extremities. The disease can appear after a fungal infection, trauma, dermatitis, ulcer formation. The most vulnerable areas of the skin are those that have excess fluid (for example, with edema). Also, panniculitis may appear in the scar area after surgery.
In the photo, inflammation of the subcutaneous tissue is difficult to notice.
Symptoms of panniculitis
The main manifestation of spontaneous panniculitis is nodular formations located at various depths in the subcutaneous fat. They usually appear on the legs and arms, rarely on the stomach, chest and face.
After nodal destruction, atrophied foci of adipose tissue remain in the form of round areas of skin retraction. The nodal variant is distinguished by the appearance of typical nodes in fiber under the skin ranging in size from three millimeters to five centimeters.
The skin of the skin over the nodes can be painted in a normal color or be bright pink. With a plaque type of inflammation of the subcutaneous adipose tissue , separate nodal clusters appear, which grow together and form tuberous conglomerates.
Above such formations, the skin can be burgundy-cyanotic, burgundy or pink. In some cases, nodal clusters extend completely to the fiber of the shoulder, lower leg or thigh, compressing the vascular and nerve bundles. Because of this, obvious pain appears, lymphostasis develops, limbs swell.
The infiltrative type of the disease occurs with the fusion of nodes and their conglomerates. In the area of a knot or plaque, the skin is bright red or burgundy. Then a fluctuation occurs, which is characteristic of abscesses and phlegmon, however, when the nodes are opened, a yellow oily mass is released, and not pus. A ulcer that does not heal for a long time will remain in place of the revealed node.
With a mixed type of panniculitis, the nodal form passes into the plaque, then - into the infiltrative. This option is noted in rare cases. At the onset of the disease, there may be fever, muscle and joint pain, nausea, headaches, general weakness. With the visceral type of the disease , systemic inflammation of adipose tissue occurs throughout the human body with the formation of specific nodes in the tissue behind the peritoneum and omentum, pancreatitis, hepatitis and nephritis. Panniculitis can last from two to three weeks up to several years.
Diagnostic Methods
Inflammation of the subcutaneous tissue, or panniculitis, is diagnosed by a joint examination of a dermatologist and nephrologist, rheumatologist, gastroenterologist. Urine and blood tests are used, pancreatin enzyme assay, Reberg test, liver tests. The determination of nodes with visceral panniculitis is due to ultrasound examination of the abdominal organs and kidneys. Blood culture for sterility helps to eliminate the septic orientation of the disease. An accurate diagnosis is made after receiving a biopsy of the formation with histological analysis.
Classification
There is a primary, spontaneous and secondary form of inflammation of the subcutaneous tissue. Secondary panniculitis are:
- immunological panniculitis - often occurs with systemic vasculitis;
- lupus panniculitis (lupus) - with a deep lesion of systemic lupus erythematosus;
- enzymatic panniculitis - associated with the influence of pancreatic enzymes;
- proliferative cell panniculitis - with lymphoma, histiocytosis, leukemia, etc.
- cold panniculitis - a local form that develops as a reaction to exposure to cold;
- steroid panniculitis - appears in children after completion of corticosteroid treatment;
- artificial panniculitis - caused by the introduction of drugs;
- crystalline panniculitis - appears with renal failure, gout due to deposition of fiber calcifications, urate;
- hereditary panniculitis, which is caused by a lack of α1-antitrypsin.
In the form of nodes, nodal, plaque and infiltrative types of the disease are distinguished.
Patient Actions
If the first signs of panniculitis appear, you need to see a doctor. Among other things, when detecting new symptoms, resort to medical care (constant fever, drowsiness, high fatigue, the formation of blisters and the expansion of the redness).
Treatment features
A method of treating inflammation of the subcutaneous tissue is determined by its course and form. With chronic nodular panniculitis, non-steroidal anti-inflammatory drugs are used (Ibuprofen, Diclofenac Sodium), antioxidants (vitamins E and C); Chip nodular formations with glucocorticoroids. Physiotherapeutic procedures are also effective: phonophoresis of hydrocortisone, ultrasound, UHF, laser therapy, ozokerite, magnetotherapy.
In the plaque and infiltrative type, the subacute course of the disease is characterized by the use of glucocorticosteroids (Hydrocortisone and Prednisolone) and cytostatics (Methotrexate). Secondary forms of the disease are treated with disease therapy against the background of vasculitis, gout, pancreatitis and systemic lupus erythematosus.
From panniculitis, a preventive measure is the timely diagnosis and therapy of primary pathologies - bacterial and fungal infections, vitamin E deficiency.
How is inflammation of the subcutaneous tissue on the legs?
Cellulite
Cellulite, or gynoid lipodystrophy, is caused by structural changes in adipose tissue, often leading to severe deterioration of blood microcirculation and lymph congestion. Not all experts consider cellulite to be a disease, but insist that it can be called a cosmetic defect.
Such inflammation of subcutaneous fat in the photo is presented.
Cellulite predominantly occurs in women as a result of hormonal disruptions that periodically occur: adolescence, pregnancy. In some cases, its appearance can provoke the use of hormonal-type contraceptives. Great importance belongs to the factor of heredity and the specificity of the diet.
How to get rid?
Lipodystrophy of the tissue under the skin is treated necessarily comprehensively. To succeed, you need to eat properly, drink multivitamins, antioxidants. A very important part of the treatment is sports and active breathing.
Doctors advise a course of procedures to improve blood and lymph circulation - bioresonance stimulation, massage, press and magnetotherapy. Fat cells become smaller after mesotherapy, ultrasound, electrolyolysis and ultraphonophoresis. Use special creams against cellulite.