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| Fig. 19.8 Sclerosing panniculitis with lipoatrophy caused by repeated injection of pentazocine. (Courtesy of Kenneth E. Greer, MD.) |
Numerous forms of trauma, either accidental or purposeful, can produce painful subcutaneous nodules or plaques. These include cold injury (“popsicle panniculitis” on the cheeks of children), injection of foreign substances such as oils or medications (Fig. 19-8), or blunt force trauma. There are some unique microscopic clues for each of these types of injury, so biopsy is particularly helpful when traumatic panniculitis is suspected. Polarization microscopy is one simple test for detecting the presence of refractile foreign material in tissue sections. The therapeutic challenge lies mainly in finding and removing the source of the injury that has produced the panniculitis.
