Lupus panniculitis in Child
This entity is rare in the pediatric population, and its exact prevalence is unknown. The mean age of onset is 8 years old among those cases reported. Most patients do not have concurrent systemic lupus erythematosus (SLE), and extensive laboratory evaluation is not indicated in the absence of systemic symptoms.
L93.2 – Other local lupus erythematosus
239888002 – Lupus panniculitis
Differential Diagnosis & Pitfalls
- Morphea – Usually presents with purplish borders, fewer nodules, and less facial involvement.
- Sarcoidosis – Less induration, more epidermal changes.
- Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) – Can present similarly both clinically and histologically to lupus panniculitis. Clinical features favoring SPTCL include the presence of systemic symptoms, leukopenia, and a high erythrocyte sedimentation rate. On histopathology, the presence of a polyclonal T-cell infiltrate, mixed CD4/CD8 population, and negative T-cell gene rearrangement studies all favor the diagnosis of lupus panniculitis over SPTCL. Lupus panniculitis lesions contain a higher percentage of CD123-positive plasmacytoid dendritic cells compared to SPTCL.
- Other panniculitides – Requires pathologic tissue examination to differentiate. See panniculitis.