Localized lipoatrophy (atrophic connective tissue disease panniculitis)

Abstract

Four patients with localized lipoatrophy were observed. All were female, and three were children. Lymphocytic panniculitis was observed in early biopsy specimens of all four cases, with focal histiocytic granulomas in one case. Later biopsy specimens in three patients showed that the inflammation was transient. These pathologic findings and reports of lipodystrophies associated with nephritis, hypocomplementemia, and other inflammatory or immunologic disorders offer an opportunity for histologic and immunologic study of such patients. Localized lipoatrophy may represent the end stage of panniculitis in a localized expression of connective tissue disease.

Annular lipoatrophy of the ankles

“…Annular lipoatrophy most resembles atrophic connective tissue disease panniculitis, and it has been suggested that annular lipoatrophy of the ankles may indeed simulate the end stage of atrophic connective tissue disease panniculitis. 4,5 Other entities in the differential diagnosis of the localized form of lipoatrophy include abdominal lipoatrophy, semicircular lipoatrophy, and postinjection localized lipoatrophy. 6 Our patient had ring-like bands of lipoatrophy encircling the ankles and associated thyroid disease.…”

“…Some patients have responded to oral glucocorticosteriods and antimalarials. 4 Further treatment options have included nonsteroidal anti-inflammatory drugs (NSAIDs), potassium iodide, and dapsone cited as unpublished cases. In cases where there is cosmetic deformity, reconstructive surgery is a consideration.…”

Unilateral Atrophy of the Cheek

“…12 Although localized unilateral atrophy of the cheek is a recognized result of inflammatory panniculitides, the data from our patient do not support the existence of an early inflammatory phase in this region. 23,24 The only remarkable aspect in the patient's medical history was a zygoma bone fracture on the left side 35 years ago. It is possible that this trauma had an etiological influence on the atrophy of the cheek on the same side, although the patient dates the beginning of atrophy as only 3 years previously.…”

Idiopathic Localized Involutional Lipoatrophy: A Lupus Profunds-like Condition

“…Idiopathic localized involutional lipoatrophy (ILIL) is a rare and nosologically imprecise condition characterized by a focal loss of subcutaneous tissue on one or several sites, occurring without any significant triggering factor or auto-immune background, and regressing spontaneously within a few months (1,2). We report here on a new observation of ILIL that emphasizes its deceitful clinical resemblance to lupus profundus and the necessity for clinicians to be aware of this unusual differential diagnosis of better prognosis.…”