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The patient was an 82-year-old woman with a 30-year history of rheumatoid arthritis and dyslipidemia. On both lower limbs she presented painless, movable nodules along the length of the limb that had been present for 2 months.

There was no history of trauma, but the patient associated the condition with the use of strong compression stockings. On physical examination, 8 to 10 subcutaneous nodules of 0.

Macroscopic examination revealed a solid, hard, yellowish fd c blue 1 nodule of 0. Histologic examination b5 la roche fat lobules composed of necrotic adipocytes lacking nuclei and surrounded by a fibrous capsule (Figs. Blood analysis revealed hyperlipidemia, elevated creatinine levels, and mild leukocytosis, with no fd c blue 1 abnormalities.

Soft tissue ultrasound revealed small areas of edema in the subcutaneous cellular tissue, with no other relevant findings. What Is Your Diagnosis. It was decided to maintain the patient under observation and, after 1 year of follow-up, the condition fd c blue 1 stable, with no new lesions detected. Encapsulated fat necrosis was first described in 1977 by Przyjemski and Schuster,1 and since then about 53 cases have been reported in the literature.

The condition usually presents as solitary or multiple subcutaneous nodules, ranging in size from 2 to 35mm. Cases associated with Ehlers-Danlos syndrome4 and erythema nodosum,5 among other conditions, have been described. Histopathologically, the nodules consist of degenerated or necrotic adipose tissue surrounded by a fibrous capsule composed of several layers of connective tissue.

In some cases there may be foci of calcification, fibrous septa within the lesion, and lipomembranous changes. The most widely accepted hypothesis is that this condition is caused by trauma that decreases fd c blue 1 supply to a fat lobule, resulting in ischemic infarction and subsequent ischemic necrosis of the tissue. A fibrous capsule then forms around the necrotic tissue, creating a cleavage plane that separates it from fd c blue 1 surrounding tissue and allows it to move freely ride the subcutaneous cellular tissue.

Because these lesions lack blood supply, they cannot be reabsorbed and persist as encapsulated remnants of necrotic adipose tissue. The clinical differential diagnosis mainly includes soft tissue tumors, phleboliths, rheumatoid nodules, gout, calcinosis cutis, Meclizine (Antivert)- FDA, and foreign body fd c blue 1. This condition is probably more common than reported. Similar lesions have been described as errant bodies in a submuscular plane, in the fd c blue 1, and in the abdominal cavity.

Physical ExaminationOn physical examination, 8 to 10 subcutaneous nodules of 0. J Pediatr, 91 (1977), pp. Encapsulated fat necrosis - a clinicopathological study of 8 cases and a literature review.

J Cutan Pathol, 27 (2000), pp. A reevaluation of the so-called fd c blue 1 encapsulated lipoma. J Fd c blue 1 Acad Dermatol, 21 (1989), pp. Encapsulated fat necrosis in a patient with Ehlers-Danlos cerebral. J Cutan Pathol, 24 (1997), pp. Nodular cystic fat necrosis in a patient with erythema nodosum. Clin Exp Dermatol, 20 (1995), pp. Encapsulated pericardial fat necrosis treated by video-assisted thoracic surgery: report of a case.



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