Post-steroid panniculitis

Introduction to post-steroidal panniculitis Post-steroidal panniculitis often stops after a large dose of steroids, or subcutaneous nodular panniculitis caused by excessive reduction, and Spagnuolo is named after steroid hormone panniculitis. basic knowledge The proportion of illness: 0.04%-0.08% Susceptible people: no special people Mode of infection: non-infectious Complications: femoral head necrosis

Causes of post-steroidal panniculitis

(1) Causes of the disease

Spagnuolo believes that the disease is a complication of steroid hormones.

(two) pathogenesis

The pathogenesis is still unclear. Spagnuolo believes that due to the cessation of steroid hormones, the loss of lipase in the fat cells caused by loss of fat deposition is lost, causing degeneration and damage of fat cells.

Post-steroidal panniculitis prevention

Avoid large doses of steroids or stop using them and stop gradually.

Post-steroidal panniculitis complications Complications femoral head necrosis

Because the disease is related to the use of steroid hormones, due to the use of adrenocortical hormones, patients may have a redistribution of adipose tissue, such as increased distribution of adipose tissue in the back and face, and a decrease in the distribution of adipose tissue in the extremities, which we call Centripetal obesity. Secondly, a large number of steroid hormones can cause calcium loss, which can lead to aseptic femoral head necrosis.

Post-steroidal lipid inflammatory symptoms Common symptoms Nodular joint pain Lipitis fever

Usually around 2 weeks after the steroid hormone is stopped, there are subcutaneous nodules of different sizes. The quality is hard, the boundary is clear, there is tenderness, and the surface color of the skin lesions is normal or flushed. It is more common in children. The skin lesions are often found in the areas where the subcutaneous fat is most stored. Such as the buttocks, torso, proximal limbs, etc., the disease can naturally subside after weeks or months, systemic symptoms are absent, sometimes there may be fever, joint pain, severe heart may have heart, intestinal fat accumulation It can even cause heart failure or gastrointestinal symptoms and endanger life.

Examination of post-steroidal panniculitis

Histopathology: inflammatory infiltration of neutrophils and monocytes in the early stage of subcutaneous fat lobules, late appearance of tissue cells, foam cells, infiltration of lymphocytes and foreign body giant cells, degeneration of fat cells, needle-like crystals in cells, Similar to the neonatal subcutaneous fat necrosis, the fat crystals are seen, and even the entire intestinal panniculitis lesion can be seen.

Diagnosis and identification of post-steroidal panniculitis

diagnosis

According to the clinical manifestations, the characteristics of skin lesions and histopathological features can be diagnosed.

Differential diagnosis

It should be differentiated from nodular panniculitis, and nodules should be taken for histopathological examination.

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