title: Pancreatic panniculitis - a cutaneous manifestation of acute pancreatitis.
abstract: BACKGROUND
  Pancreatic panniculitis is a rare complication of pancreatic disease occurring in 2% to 3% of all patients, most commonly those with acute or chronic pancreatitis.
  
  
  METHODS
  We report the case of a pancreatic panniculitis associated with acute pancreatitis in a 63-year-old man. He presented with a 2-day history of multiple tender subcutaneous nodules, followed by nausea, vomiting, severe epigastric pain and loss of appetite, hours before admission. Laboratory and radiologic findings revealed acute pancreatitis. Histopathological examination from a skin biopsy specimen taken from a nodule showed a mostly lobular panniculitis with "ghost cells", without vasculitis. Nodules disappeared with the resolution of acute pancreatic inflammation, as amylase and lipase levels returned to normal.
  
  
  CONCLUSIONS
  Panniculitis may be the first manifestation of pancreatic disease. Therefore clinicians must have a high index of suspicion for the diagnosis of pancreatic panniculitis.
authors.affiliation: Department of Dermatology and Venereology, Hospital de Curry Cabral - Centro Hospitalar de Lisboa Central, Lisboa, Portugal;
authors.forename: André
authors.initials: A
authors.lastname: Laureano
authors.affiliation: Department of Dermatology and Venereology, Hospital de Curry Cabral - Centro Hospitalar de Lisboa Central, Lisboa, Portugal;
authors.forename: Tiago
authors.initials: T
authors.lastname: Mestre
authors.affiliation: Department of Gastroenterology, Hospital Fernando da Fonseca, Amadora, Portugal.
authors.forename: Leonel
authors.initials: L
authors.lastname: Ricardo
authors.affiliation: Department of Dermatology and Venereology, Hospital de Curry Cabral - Centro Hospitalar de Lisboa Central, Lisboa, Portugal;
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Rodrigues
authors.affiliation: Department of Dermatology and Venereology, Hospital de Curry Cabral - Centro Hospitalar de Lisboa Central, Lisboa, Portugal;
authors.forename: Jorge
authors.initials: J
authors.lastname: Cardoso
keywords: acute pancreatitis; adypocites; arthritis; chronic pancreatitis; differential diagnosis; erysipelas; erythema nodosum; fever
references.citation: Dermatol Ther. 2010 Jul-Aug;23(4):368-74
references.pmid: 20666824
references.citation: J Cutan Med Surg. 2008 Jan-Feb;12(1):38-42
references.pmid: 18258147
references.citation: Clin Exp Dermatol. 2010 Apr;35(3):e65-6
references.pmid: 20500185
references.citation: J Am Acad Dermatol. 2001 Sep;45(3):325-61; quiz 362-4
references.pmid: 11511831
references.citation: Br J Rheumatol. 1995 Jul;34(7):680-3
references.pmid: 7670790
references.citation: Eur J Dermatol. 2009 Mar-Apr;19(2):191-2
references.pmid: 19106060
references.citation: Dermatol Clin. 2008 Oct;26(4):465-70, vi
references.pmid: 18793978