Pancreatic panniculitis (PP) is a rare cutaneous manifestation of pancreatic disease, often presenting as tender, erythematous, subcutaneous nodules, typically on the lower extremities. It can also affect the upper extremities, buttocks, and abdomen. PP is associated with conditions such as acute pancreatitis, pancreatic acinar cell carcinoma, and pancreatic adenocarcinoma. In some cases, PP occurs as part of pancreatitis, panniculitis, and polyarthritis (PPP) syndrome, a clinical trial that also involves aseptic polyarthritis. While the pathophysiology of PP is not fully understood, cutaneous findings often resolve as pancreatic enzyme levels normalize. This study aims to summarize and characterize the demographics, distribution, morphology, symptoms, etiology, management, and outcomes of PP.
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http://dx.doi.org/10.7759/cureus.78000 | DOI Listing |
Rheumatol Int
March 2025
Department of Rheumatology and Connective Tissue Diseases, Medical University, St. Jaczewskiego 8, 20-090, Lublin, Poland.
Pancreatic panniculitis (PP) and arthritis may be extrapancreatic manifestations of pancreatic disease. The triad of pancreatic disease, panniculitis and polyarthritis, described in the literature as the PPP syndrome, is sometimes observed in patients with acute or chronic pancreatitis, pancreatic cancer or neuroendocrine tumors (NETs). We present a 60-year-old man with polyarthritis and clinically aggressive PP of the limbs.
View Article and Find Full Text PDFJ Gastroenterol Hepatol
March 2025
Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Japan.
A 73-year-old female with type 1 autoimmune pancreatitis (AIP) presented with painful erythema on her lower extremities and elevated serum pancreatic enzyme levels. Her CT images revealed focal enlargement of the pancreatic tail with an increased density of the surrounding fatty tissue. Based on serum and CT findings, she was diagnosed as having acute deterioration of AIP.
View Article and Find Full Text PDFCureus
January 2025
Department of Dermatology, Lewis Katz School of Medicine at Temple University, Philadelphia, USA.
Pancreatic panniculitis (PP) is a rare cutaneous manifestation of pancreatic disease, often presenting as tender, erythematous, subcutaneous nodules, typically on the lower extremities. It can also affect the upper extremities, buttocks, and abdomen. PP is associated with conditions such as acute pancreatitis, pancreatic acinar cell carcinoma, and pancreatic adenocarcinoma.
View Article and Find Full Text PDFAm J Dermatopathol
February 2025
Department of Dermatology and Venereology, 1st Hospital of Jilin University, Changchun, China.
A 66-year-old male patient presented to our department with subcutaneous nodules in both lower extremities accompanied by pain. Skin pathology suggested pancreatic panniculitis. Subsequent imaging and histopathology identified a rare case of pancreatitis-panniculitis-polyarthritis syndrome secondary to a primary hepatic neuroendocrine tumor.
View Article and Find Full Text PDFACG Case Rep J
February 2025
Department of Medical Gastroenterology, Sawai Man Singh Medical College and Hospital, Jaipur, India.
Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome is a rare manifestation (prevalence 2%-3%) of underlying pancreatic pathology which is characterized by fat necrosis in subcutaneous tissue and joints. The widely accepted etiological hypothesis is systemic dissemination of pancreatic lipase. It has a mortality rate approaching 25%.
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