Abstract NODOSE lesions of the lower extremities are most frequently due to inflammatory reactions which are primarily localized in the subcutaneous fat, its connective tissue septums and blood vessels. The changes in the overlying cutis and epidermis are secondary to those in the subcutaneous fat and its septums and vessels. These nodes and lesions have an intense central reaction which gradually recedes at the periphery, with the formation of the indistinct borders observed clinically. Atrophic changes in the fat lobules were classified into four types by Flemming in 1871, according to Schidachi.1 The first type is simple atrophy, in which the individual cells become smaller. The contained fat globules are smaller, and thus the volume of fat cells in the fat lobule is diminished. The second type is the result of liquefaction or serous degeneration. In this sort of change the fat globule becomes smaller. A serous substance is found References 1. Schidachi, T.: Über die Atrophie des subkutanen Fettgewebes , Arch. f. Dermat. u. Syph. 90:97-130, 1908.Crossref 2. Bergstrand, H.: Is Erythema Nodosum a Hypersensibility Reaction of Anaphylactic Type? Acta dermat.-venereol. 29:539-543, 1949. 3. Zeek, P. M.; Smith, C. C., and Weeter, J. C.: Studies on Periarteritis Nodosa: III. The Differentiation between the Vascular Lesions of Periarteritis Nodosa and of Hypersensitivity , Am. J. Path. 24:889-919, 1948. 4. Middelmis, J. H.: Erythema Nodosum , Brit. J. Radiol. 22:375-383, 1949.Crossref 5. Bergstrand, H.: Morphological Equivalents in Polyarthritis Rheumatica, Periarteritis Nodosa, Transient Eosinophilic Infiltration of the Lung and Other Allergic Syndromes , J. Path. & Bact. 58:399-409, 1946. 6. Löfgren, S., and Wahlgren, F.: On the Histo-Pathology of Erythema Nodosum , Acta dermat.-venereol. 29:1-13, 1949. 7. Miescher, G.: Zur Histologie des Erythema nodosum , Acta dermat.-venereol. 27:447-468, 1947. 8. Ophüls, W.: Periarteritis Acuta Nodosa , Arch. Int. Med. 32:870-898 ( (Dec.) ) 1923. 9. Montgomery, H.; O'Leary, P. A., and Barker, N. W.: Nodular Vascular Diseases of the Legs: Erythema Induratum and Allied Conditions , J. A. M. A. 128:335-341 ( (June 2) ) 1945. 10. Pfeifer, V.: Über ein Fall von herdweiser Atrophie des subcutanen Fettgewebes , Arch. f. klin. Med. 50:438-449, 1892. 11. Gilchrist, T. C., and Ketron, L.: A Unique Case of Atrophy of the Fatty Layer of the Skin, Preceded by Ingestion of Fat by Large Phagocytic Cells—Macrophages , Bull. Johns Hopkins Hosp. 27:291-294, 1916. 12. Weber, F. P.: A Case of Relapsing Non-Suppurative Nodular Panniculitis Showing Phagocytosis of the Subcutaneous Fat Cells by Macrophages , Brit. J. Dermat. 37:301-311, 1925. 13. Christian, H. A.: Relapsing Febrile Nodular Non-Suppurative Panniculitis , Arch. Int. Med. 42:338-351 ( (Sept.) ) 1928. 14. Keil, H.: Panniculitis: Its Place in Nosology , Brit. J. Dermat. 47:512-521, 1935. 15. Carol, W. L. L.; Prakken, J. R., and Van Zwijndregt, H. A.: Erythema Nodosum und "Relapsing Febrile Nodular Non-Suppurative Panniculitis,'' Arch. f. Dermat. u. Syph. 182:329-366, 1941. 16. Rich, A. R.: The Role of Hypersensitivity in Periarteritis Nodosa as Indicated by 7 Cases Developing During Serum Sickness and Sulfonamide Therapy , Bull. Johns Hopkins Hosp. 71:123-135, 1942.
A.M.A. Archives of Dermatology & Syphilology – American Medical Association
Published: Mar 1, 1951