Relapsing Febrile Nodular Nonsuppurative Panniculitis (Weber-Christian Disease)

Panniculitis in Childhood

“…Fifteen of the 20 children with nonfatal panniculitis had focal atrophic changes after healing of the subcutaneous lesions. In some, depressions developed occasionally in areas without obvious antecedent lesions, while in others, nodules occasionally disappeared leaving no trace (18). The iipoatrophy in these patients follovvfed a few defined patterns:…”

“…1, 2), the cheeks in three (13,16; pt, no. 2), The hand was involved in one (12); the foot in two (11,18),…”

“…The lesions appeared singly or in crops and persisted for a variable period of time ranging from a week or less (14,18) to several months. The overlying skin color varied considerably (normal, pink, markedly erythematous, purple, bluish, or hyperpigmented), with mild scaling in some.…”

“…1, Marked to diffuse loss of fat from the lower extremities, associated in some with small focal areas of loss on the arms and Iipoatrophy of buttock in one (16,(18)(19)(20) 2, Small to moderate-sized, multifocal, localized lipoatrophic areas that did not extend over the whole extremity, involving thigh, lower leg, and occasionally arms (18,20) 3, Localized atrophy in a semicircular pattem around the ankles (21) 4, Localized atrophic or depressed areas on the face (cheeks, bridge of nose, preauricuiar area), upper arms, shoulders, and neck after LE or connective tissue panniculitis (13,15; pt, no, 2) 5, Depressed or pitted areas in scattered distribution after liquefaction of fat and/or abscess formation (7,14) Lipoatrophy was noted in only one of the seven children with fatal panniculitis (9) and followed the second pattem. Suppuration or ulceration of lesions was noted in seven patients (4,5,7,11,12,14; pt.…”

“…2). Moderate temperature elevations (101-I02°F) were present in two patients with diffuse lower extremity fat loss (18,19) and one with focal atrophy at the ankle (21),…”