Pancreatic Panniculitis

Daniel G. Federman, MD, FACP; Jennifer M. McNiff, MD; Robert S. Kirsner, MD


Wounds. 2004;16(4) 

In This Article


A 67-year-old man was admitted to the hospital after complaining of painful lower-extremity ulcers and two days of fever. One month prior to admission, he developed a raised, red, nodular lesion on his right lateral foot and over the next few weeks developed multiple other similar lesions on his lower extremities and forearms, as well as painful bilateral lower-extremity swelling. He was recently treated with a course of antibiotics for presumed cellulitis of his lower extremities at another facility without improvement. During that time, he complained of diffuse abdominal pain and a 20-pound weight loss. A computerized tomography (CT) scan was obtained and revealed a pancreatic mass; a subsequent biopsy performed during upper endoscopy with ultrasound guidance was reportedly negative for malignancy.

His past medical history was significant for a remote history of alcohol abuse, hypertension, and peripheral vascular disease. His surgical history included a left femoral-popliteal lower-extremity bypass procedure six years before presentation and repair of a cerebral aneurysm 11 years prior to presentation. His medications included felodipine and aspirin, and he denied any known medication allergies. He denied illicit drug use but admitted to heavy alcohol consumption in the past, though he stated that he recently drank 1 to 2 cans of beer daily. He smoked one pack of cigarettes per day and had a 40-pack year smoking history.


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