PANICULITIS 3 de octubre

• A 35-year-old male presented with a 4 week history of painful subcutaneous nodules on shinsand buttocks. He had loss of weight and loss of appetite. He did not have fever, arthralgia, orchronic cough and his bowel habits were normal. He reported consumption of about half a bottleof hard liquor per day. Three months prior to presentation he had an episode of severe centralabdominal pain associated with nausea and vomiting and was diagnosed as having chronicpancreatitis.• Physical examination revealed multiple tender subcutaneous nodules over the ankle region,shins, thighs, and buttocks. The overlying skin was erythematous with no change in skin texture.None of the lesions was ulcerated. Systemic examination was normal except for mild pallor.Clinically, the possibilities of erythema nodosum, erythema induratum, or pancreatic panniculitiswere entertained. Whitish oily material was noted when performing the incisional biopsy,favoring fat necrosis.• His erythrocyte sedimentation rate (ESR) was 26 mm; hemoglobin was 9.2 g/dl with normalwhite cells and platelets and additional testing suggested anemia of chronic disease.Antistreptolysin O titer (ASOT) was