What is lupus panniculitis?

In lupus panniculitis, inflammation involves the subcutaneous tissue, resulting in inflamed nodules that often resolve with depressed scars. Lesions tend to favor the proximal extremities and trunk, which is a clinical clue differentiating this form of panniculitis from other forms of panniculitis. There may be overlying lesions of DLE. When lupus panniculitis occurs with an overlying DLE lesion, it may be called lupus profundus. About one half of patients with lupus panniculitis have four or more criteria for the classification of SLE. The diagnosis is confirmed by an adequate excisional biopsy. Small punch biopsies are not adequate to rule out other causes of panniculitis. Direct immunofluorescence examination may be helpful in establishing the diagnosis. The treatment of choice is antimalarial drugs.

Fraga J, García-Díez A: Lupus erythematosus panniculitis, Dermatol Clin 26:453–463, 2008.