Abstract

In a 16-month-old boy an unusual form of panniculitis developed after the rapid discontinuation of large doses of prednisone orally administered for an episode of acute nephrosis. A review of 16 previously reported cases is outlined; all patients but one had had acute rheumatic fever. The clinical courses of all the cases are similar. The onset of the subcutaneous nodules developed in from 1 to 13 days after withdrawal of prednisone therapy. There were few constitutional symptoms; the nodules usually disappeared spontaneously. Histopathologic study revealed needle-shaped clefts within fat cells, and infiltration of fat lobules by foam cells, histiocytes, lymphocytes, and foreign-body giant cells. The inflammatory reaction spared the interlobular septa. The pathogenesis of poststeroid panniculitis is not known, but it is regarded as a complication of orally administered corticosteroids.

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