Annular Lipoatrophic Panniculitis of the Ankles

Abstract

We report a girl with lipophagic lobular panniculitis of unknown origin located on her ankles leading to circumferential fat atrophy of the ankles, a condition usually referred to as "annular lipoatrophy of the ankles." According to our patient's features and five additional cases reported so far, we conclude that this condition is actually an end-stage manifestation of an idiopathic lobular panniculitis of children localized to the lower part of the lower limbs. An association with some autoimmune manifestations is highlighted.

Lipoatrophic Panniculitis of the Ankles in Childhood

“…In all, 15 cases have been published that can be regarded as corresponding to lipoatrophic panniculitis of the ankles in childhood [3][4][5][6]9,11,12,[14][15][16][17][18][19][20][21] (Table 1), and in 14 of them, a histopathologic study has been carried out. The presence of foamy macrophages is emphasized, together with lymphocytes and occasional polymorphs, but no systematic immunohistochemical or molecular study has been done.…”

“…2 Lipoatrophic panniculitis characteristically involving the ankles was initially reported by Shelley and Izumi 3 in 1970, and only a handful of cases have been reported ever since, 3,4 some of them under the heading of connective tissue panniculits. 6 We recently studied a case that showed focally histopathological features raising the differential diagnosis of subcutaneous panniculitislike T-cell lymphoma. 6 We recently studied a case that showed focally histopathological features raising the differential diagnosis of subcutaneous panniculitislike T-cell lymphoma.…”

Recurrent lipoatrophic panniculitis of children

“…In the last 25 years, the term ‘lipophagocytic panniculitis’ and ‘lipoatrophic panniculitis’ have been used in descriptions of case reports . Under the headline of ‘lipoatrophic panniculitis’, cases have been described involving only the ankles and although the clinical and histopathological features described may resemble the ones described in cases with generalized lesions, it remains unclear if ‘lipoatrophic panniculitis of the ankles’ represents a localized variant of the former or not. However, because all these cases were described years ago or their histopathological and immunohistochemical features were not performed or not possible to review, we are not certain if they represent the same disorder we describe in this paper.…”

Lipoatrophie annulaire des chevilles traitée par autogreffe de tissu graisseux : à propos d’un cas et revue de la littérature

“…Une autre patiente [4] était atteinte de la maladie de Basedow. Les deux dernières patientes décrites dans la littérature présentaient chacune deux pathologies auto-immunes : un diabète de type I associé à une maladie de Basedow chez une patiente de 22 ans [5], une maladie coeliaque associée à une hypothyroïdie chez une patiente de 13 ans [6].…”

“…Tous les autres patients ont été traités à la phase inflammatoire : quatre patients par corticothérapie [3,[8][9][10], un par AINS [6], un par antibiothérapie (pénicilline) [11], deux par chloroquine [5,8].…”