Also known as: lupus profundus
- Uncommon manifestation of systemic lupus erythematosus, or may occasionally be seen in the absence of the disease
- Possible relationship with subcutaneous lymphoma
- Presents with multiple indurated subcutaneous nodules, most commonly on the proximal extremities, but may occur elsewhere
- The overlying skin may show a variety of changes, including discoid lupus erythematosus, poikiloderma or ulceration.
- The overlying skin may or may not show features of systemic lupus erythematosus or discoid lupus erythematosus.
- Septal and lobular panniculitis with:
- Lymphocytic inflammation, often with lymphoid aggregates and/or follicles, at the periphery of the fat lobules
- Fequent plasma cells
- Hyaline necrosis of the fat lobules, often with karyorrhectic debris and mucin deposition
- Hyalinization of the adipose tissue, septa and blood vessels
- Often lymphocytic vasculopathy or frank vasculitis with fibrin thrombi
- Less characteristic changes that may sometimes be present include: thickening of the septa, septal granulomas and eosinophils.