title: Musculoskeletal manifestations with panniculitis--a hospital based study on 62 patients in Kuwait.
abstract: The study describes 62 patients seen over a period of 4 years mainly presenting with an acute inflammatory ankle arthritis/periarthritis associated with panniculitis. Based upon the clinical characteristics of panniculitis two distinct categories could be defined. These included patients with characteristic lesions of erythema nodosum, seen in 51 (82%), the idiopathic form in 29 (57%), and secondary EN in 22 (43%). Associated conditions included Behçet's disease, oral contraceptive pills, pregnancy and penicillin treatment. Patients clinically not having typical EN was seen in 11 (18%). In this group the histopathology showed erythema induratum in 4, cutaneous-polyarteritis nodosa with minimal panniculitis in 3, Weber-Christian disease, cytophagic histiocytic panniculitis, and 'mixed' lobular and septal variety of panniculitis in 1 each. (In 1 patient the disease was not panniculitis but cutaneous variant of granuloma annulare). It is concluded that in a hospital setting EN associated with acute musculoskeletal symptoms, mainly ankle arthritis/periarthritis or an acute peripheral polyarthritis, was a common rheumatological problem in Kuwait. However, other forms of panniculitides also presented with musculoskeletal manifestations requiring accurate histopathological diagnosis for appropriate treatment.
authors.affiliation: Department of Medicine, Faculty of Medicine, Kuwait University, Safat.
authors.forename: A N
authors.initials: AN
authors.lastname: Malaviya
authors.forename: I M
authors.initials: IM
authors.lastname: Francis
authors.forename: P
authors.initials: P
authors.lastname: Kaushik
authors.forename: E H
authors.initials: EH
authors.lastname: Ayyash
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006760:Hospitalization; D006801:Humans; D007730:Kuwait; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000150:complications / Q000473:pathology*; D015434:Panniculitis / Q000150:complications / Q000473:pathology*