A 38-year-old woman presents with firm, deep-seated nodules on the proximal arms and cheeks. Biopsy shows lobular panniculitis with hyalinised fat necrosis and lymphoid aggregates; the overlying dermis shows interface change. What is the diagnosis?

• A Erythema nodosum
• B Subcutaneous panniculitis-like T-cell lymphoma
• C Weber-Christian disease
• D Lupus panniculitis (lupus profundus) ✓

Explanation

Lupus panniculitis is a chronic variant of cutaneous lupus with firm nodules on the face, arms and buttocks. Histology shows lobular panniculitis with hyalinisation of fat lobules and interface dermatitis in the overlying epidermis, a combination that separates it from erythema nodosum, which is septal. Subcutaneous panniculitis-like T-cell lymphoma lacks interface change and shows atypical rimming lymphocytes.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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