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Locoregional Multiple Nodular Panniculitis Induced by Pseudomonas aeruginosa Without Septicemia Three Cases and Focus on Predisposing Factors

Abstract : IMPORTANCE Pseudomonas aeruginosa-induced locoregional multiple nodular panniculitis without septicemia is an underreported condition, with only 3 cases reported to date. We report 3 new cases of P aeruginosa-induced multiple nodular panniculitis without septicemia and describe common features among all 6 cases, thus providing the first description, to our knowledge, of the natural history and potential predisposing factors for this entity. OBSERVATIONS Median age of the 6 patients was 74 years (range, 54-84 years). Patients had inflammatory nodules on a lower limb (n = 6) that were unilateral (n = 6) and had no fever (n = 5). Blood cultures were negative (n = 5). Skin biopsy specimens revealed panniculitis (n = 5), with skin cultures positive for P aeruginosa (n = 6). Skin nodules resolved with systemic antibiotics (n = 5). The comorbidities recorded were type 1 or 2 diabetes mellitus (n = 5), overweight (n = 3), and combined locoregional anatomical changes in the lower limbs (n = 5). Local skin injury, which constituted the portal entry, was present in all cases, especially leg ulcers (n = 3). CONCLUSIONS AND RELEVANCE We describe P aeruginosa-induced locoregional nodular panniculitis as a distinct entity. This should be investigated in elderly, diabetic, overweight patients with inflammatory nodules on a lower limb associated with locoregional anatomical changes and skin injury, with the optimal antibiotic regimen introduced as rapidly as possible.
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https://hal.inrae.fr/hal-02633695
Contributor : Migration Prodinra <>
Submitted on : Wednesday, May 27, 2020 - 1:16:36 PM
Last modification on : Thursday, May 6, 2021 - 2:22:48 PM

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Mélanie Roriz, Annabel Maruani, Emmanuelle Le Bidre, Marie-Christine Machet, Laurent Machet, et al.. Locoregional Multiple Nodular Panniculitis Induced by Pseudomonas aeruginosa Without Septicemia Three Cases and Focus on Predisposing Factors. JAMA Dermatology, American Medical Association, 2014, 150 (6), pp.628 - 632. ⟨10.1001/jamadermatol.2013.9340⟩. ⟨hal-02633695⟩

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