|
| Fig. 19.9 A, Panniculitis caused by Mycobacterium marinum. The classic linear appearance of the lesions denotes local lymphangitic spread, common in cutaneous infections with this organism. B, Ulceronecrotic panniculitis secondary to Cryptococcus neoformans. Skin disease is most often due to hematogenous spread of primary pulmonary infection. (Courtesy of Kenneth E. Greer, MD.) |
Panniculitis can result from localized or generalized infection caused by gram-positive and gramnegative bacteria, mycobacteria (Fig. 19-9A),
Nocardia, Cryptococcus (Fig. 19-9B),
Candida, and
Fusarium species. Other organisms that have been associated with panniculitis include
streptococci, Toxocara, Trypanosoma, and Borrelia burgdorferi (as a manifestation of Lyme disease). Immunosuppressed patients appear to be particularly at risk for infection-induced panniculitis. Microscopic features vary and can occasionally mimic other forms of panniculitis. However, findings that should suggest the possibility of infection include mixed septal-lobular involvement, neutrophilic infiltration, vascular proliferation and hemorrhage, and sweat gland necrosis. Special stains and culture studies are crucial to making the correct diagnosis and instituting appropriate antimicrobial therapy.
Patterson JW, Brown PC, Broecker AH: Infection-induced panniculitis,
J Cutan Pathol 16:183–193, 1989.
