Panniculitis – Pancreatic Panniculitis

Pancreatic Panniculitis is a skin condition that I occasionally encounter in both my The Woodlands dermatology and Conroe dermatology offices.  It arises most commonly from either pancreatitis or pancreatic carcinoma.  Other causes of Pancreatic Panniculitis are pseudocysts, anatomic pancreatic abnormalities, or medication induced pancreatitis.  The most common type of pancreatic cancer causing Pancreatic Panniculitis is acinar cell carcinoma.  Clinically, the skin lesions appear as tender red nodules, however in some cases the lesions are painless.  The lower legs are the most common site for these nodules to appear.  Typically, the skin lesions spontaneously resolve leaving a residual atrophic scar.  In some patients, the lesions can rupture through the surface of the skin oozing out a viscous oily substance.  Many patients also experience arthritis in joints adjacent to the panniculitis caused by the fat necrosis that has permeated into the joint.  Diagnostic tests for Pancreatic Panniculitis include an elevated amylase and lipase (pancreatic enzymes).  Treatment involves diagnosing the cause of the pancreatitis and treating the underlying problem.