What is the significance of diagnosing lupus panniculitis?

Panniculitis may be a presenting finding of either cutaneous or systemic lupus erythematosus, or rarely of dermatomyositis or other autoimmune diseases. A small percentage of patients presenting with lupus panniculitis fulfill criteria for systemic lupus erythematous, and other complications have been reported, such as the development of antiphospholipid antibody syndrome. Antinuclear antibodies are common, and occasionally other circulating antibodies are detected, such as antineutrophil cytoplasmic antibodies. Because of the unusual clinical locations of lupus panniculitis, the true diagnosis may not be suspected for months or years. Early biopsy and direct immunofluorescence study of these lesions may provide the first clues to the diagnosis of lupus erythematosus and allow for early institution of appropriate therapy. Treatments for the panniculitis include intralesional corticosteroids, systemic antimalarials, and dapsone.