Mr.Amir (DVT of CALF),Erythema Nodosum,Genital Ulcer & Panniculitis BECHET'S DISEASE

Diagnosis: Mr.Amir (DVT of CALF),Erythema Nodosum,Genital Ulcer & Panniculitis BECHET'S DISEASE

Case submitted by Dr.Azeem Alam Khan to the dermRounds community.

Clinical Presentation

Clinical photograph(s) submitted for peer review and discussion.

Clinical History

Submitted by Dr.Azeem Alam Khan. Originally posted May 13, 2009.

Treatment

See case discussion.

Differential Diagnosis

• Panniculitis (other forms) • Cellulitis • Superficial thrombophlebitis • Polyarteritis nodosa • Sweet syndrome • Vasculitis • Insect bite reactions • Sarcoidosis (subcutaneous)

Key Learnings

• Most common form of panniculitis — septal panniculitis without vasculitis • Bilateral, pretibial, tender, erythematous nodules • Etiology: infections (Streptococcus #1), sarcoidosis, IBD, drugs (OCPs, sulfonamides), pregnancy, idiopathic (~50%) • Biopsy shows septal panniculitis with Miescher's radial granulomas — pathognomonic • Self-limited, resolves in 3-6 weeks without scarring or ulceration • Lesions evolve through bruise-like color changes (erythema → violaceous → yellow-green) • No biopsy needed if classic presentation — biopsy for atypical or persistent cases

Tags: mramir, dvt, calferythema, nodosumgenital, ulcer, amp, panniculitis, bechet039s, dr.azeem alam khan