Lipodystrophia centrifugalis abdominalis infantilis – Immunohistochemical Demonstration of an Apoptotic Process in the Degenerating Fatty Tissue

Abstract

We report a case of lipodystrophia centrifugalis abdominalis infantilis (LCAI) showing apoptosis during the lipoatrophic process by immunohistochemical staining. A 3-year-old boy was seen with a 3-month history of a centrifugally spreading depressed eruption without pain and pruritus on his abdomen. He had fever, diarrhea and vomiting for a week at the beginning of his eruption. Physical examination revealed a palm-sized well-demarcated atrophic plaque on his lower abdomen and left inguinal fold. His plaque showed fine erythema peripherally. A skin biopsy specimen showed remarkably decreased subcutaneous fatty tissue. Inflammatory cell infiltration including lymphocytes and histiocytes was noted in the degenerating fatty tissue. In the degenerating subcutaneous fatty tissue, positive staining for HLA-DR, Fas, bcl-2, p53 and transferase-mediated uridine nick end labeling in mononuclear cells were observed. He was diagnosed as having LCAI. The present case showed the possible involvement of apoptosis in the fatty tissue degeneration in LCAI.

Lipodystrophia Centrifugalis Abdominalis Infantilis: Statistical Analysis of 168 Cases

“…Lipolysis, liponecrosis, lipo‐degeneration, and foam cells were occasionally observed in the fatty tissue. Okita et al (13) observed positive staining for HLA‐DR, Fas, bcl‐2, p53, and transferase‐mediated uridine nick end labeling (TUNEL) in mononuclear cells in subcutaneous fatty tissue of a patient, suggesting the involvement of apoptosis in fatty tissue alterations. Recent research shows that leptin plays an important role in fat metabolism.…”

Lipodystrophia Centrifugalis Abdominalis Infantilis

“…5 In addition, observations of fat necrosis and lipolysis are infrequent. 7 The differential diagnosis for our patient included morphea, lichen sclerosus et atrophicus, atrophoderma of Pasini and Pierini, traumatic panniculitis, infectious panniculitis, and lupus erythematous profundus. Of these, morphea has the most clinical overlap.…”

Lipodystrophia centrifugalis abdominalis infantilis in a Caucasian girl: report of a case with perieccrine inflammation

“…Mild fibrosis and thickening of the septa have been described, but collagen bundles are not enlarged or compactly arranged 11 . A report by Okita et al 12 performing immunohistochemistry staining of the subcutaneous fatty tissue was positive for HLA‐DR, Fas, bcl‐2 and a TUNEL assay suggesting apoptosis was taking place. Biopsy from the erythematous margin tends to show a lobular panniculitis consisting of lymphocytes, histiocytes and plasma cells with a few multinuclear giant cells and neutrophils 7 .…”