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Lupus Panniculitis — SCE Dermatology MCQ

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HardConnective Tissue & VasculitisLupus PanniculitisSCE Dermatology

A woman with systemic lupus develops deep painful nodules that heal with lipoatrophy. Biopsy shows lymphocytic lobular panniculitis, hyaline fat necrosis and lymphoid follicles. Which diagnosis is most likely?

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Correct answer: D — Lupus panniculitis

Lupus panniculitis is a lymphocytic lobular panniculitis with hyaline fat necrosis and lymphoid aggregates or follicles, often followed by lipoatrophy. Cytological atypia, adipocyte rimming and a cytotoxic phenotype would raise concern for subcutaneous panniculitis-like T-cell lymphoma.

Reference: https://academic.oup.com/bjd/pages/bad-guidelines