nodular fat necrosis
Introduction
Introduction to nodular fatty necrosis Nodular fat necrosis (nodularfatnecrosis), also known as pancreatitis subcutaneous fat necrosis, Chiai describes fatty necrotic inflammation with pancreatic disease, in addition to subcutaneous fat necrosis and facet synovitis, can also cause pancreas and its surrounding omentum Mesenteric fat necrosis, skin damage manifested as repeated, massaging of tender subcutaneous nodules or erythema. basic knowledge The proportion of illness: the incidence rate is about 0.05% - 0.07% Susceptible people: no special people Mode of infection: non-infectious Complications: Mildew
Cause
Cause of nodular fatty necrosis
(1) Causes of the disease
Pancreatic disease releases pancreatic lipase causing disseminated vasculitis, causing fat necrotic inflammation, sometimes pancreatic lipase is reduced or normal, and lipid membrane inflammation may also subside. There are exceptions, indicating that pancreatic disease or pancreatic lipase is not increased. Partial fat necrosis occurs.
(two) pathogenesis
The pathogenesis is still inaccurate. Pancreatic disease releases pancreatic lipase to cause disseminated vasculitis, which causes fat necroinflammation, and there are exceptions.
Prevention
Nodular fat necrosis prevention
Early application of physical therapy to promote absorption, local topical application of blood circulation to remove blood stasis. If the mass is centrally liquefied, there is fluctuation or secondary infection, drainage should be performed, and antibiotics may be used in some cases. The trauma is not certain, and the diseased tissue should be removed for pathological examination. Cases have a clear history of trauma, such as impact, falls, crushing, surgery, and puncture. However, in a few cases, the trauma is minor.
Complication
Nodular fat necrosis complications Complications
After the tissue of the body is traumatized, the breast skin first appears ecchymosis, nodular mass, skin adhesion, internal nipple, axillary lymph node and the history of trauma is unclear. It should be differentiated from adenocarcinoma, develop progressively, without trauma and skin. Freckle. There are various kinds of damage such as abscess, sinus, papules, nodules, cysts, scars and so on. A lipid-containing cyst or flaky calcification, which is associated with a disease of sand-like calcification.
Symptom
Nodular fat necrosis symptoms Common symptoms Aversion to chills, jaundice, nausea, abdominal distension, subcutaneous nodules, abdominal pain, abdominal pain, osteoporosis cyst
Skin lesions are widely distributed subcutaneous nodules erythema, appearing in batches, bulging leather surface, showing reddish or flushing, soft, tender, sometimes fluctuating, liquefaction spills oily liquid, ulceration, ulceration, regression Does not form atrophic depression, such as the occurrence of small and medium joint synovitis, redness around the joint, the distal joint (toe) joints, similar to gout, may have osteoporosis, acute or chronic pancreatic lesions (including pancreatitis, pancreatic tumor or cyst In addition to pancreatic inflammatory systemic symptoms, fever, chills, nausea, vomiting and bloating, abdominal pain or jaundice, laboratory tests see elevated serum lipase, or eosinophils, erythrocyte sedimentation rate, skin damage often occurred in the calf, accidental Also on the hips, torso and upper limbs.
Examine
Nodular fat necrosis
Laboratory tests showed elevated blood lipidase, or increased eosinophils and accelerated erythrocyte sedimentation rate.
Histopathology: characterized by fatty lobular necrosis, inflammatory infiltration of necrosis, neutrophils, lymphocytes, tissue cells, foam cells and foreign body giant cells, visible non-nuclear fat cells, basophilic granules in the cytoplasm, cell wall Blurred light staining, called shadowy fat cells, late, localized granular calcium deposition.
Diagnosis
Diagnosis and diagnosis of nodular fatty necrosis
According to the clinical manifestations, the characteristics of skin lesions, histopathology, and the characteristics of serum tests can be diagnosed.
Differential diagnosis
1. Weber-Christian panniculitis: There is regression of irregular fever, no arthritis symptoms.
2. Indurated erythema: It is a skin tuberculosis disease, and the skin lesions are mostly distributed in the flexor of the lower leg, no obvious systemic symptoms, no pancreatic disease.
3. Nodular erythema: more related to rheumatism, skin lesions are mostly distributed on the calf extension side, nodules are not broken, without pancreatic disease.
4. Nodular vasculitis: It is an immune disease. The nodules are often arranged along the direction of the blood vessels. They are strip-like or fusiform hard nodules, rarely ruptured.
