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Connective tissue panniculitis in a child with vitiligo and Hashimoto's thyroiditis
Author(s) -
Mirza Basit,
Muir James,
Peake Jane
Publication year - 2006
Publication title -
australasian journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.67
H-Index - 53
eISSN - 1440-0960
pISSN - 0004-8380
DOI - 10.1111/j.1440-0960.2006.00223.x
Subject(s) - medicine , hydroxychloroquine , lipoatrophy , thyroiditis , vitiligo , panniculitis , thyroid , anti nuclear antibody , euthyroid , dermatology , pathology , autoantibody , immunology , antibody , disease , covid-19 , human immunodeficiency virus (hiv) , antiretroviral therapy , viral load , infectious disease (medical specialty)
SUMMARY A 9‐year‐old girl presented with a 6‐month history of inflamed tender nodules in the pretibial area. These eventually healed leaving depressed areas of atrophy and loss of subcutaneous tissue. Histology showed a predominantly lymphocytic lobular panniculitis, consistent with connective tissue panniculitis. Investigations revealed an elevated thyroid stimulating hormone, elevated thyroid antiperoxidase antibody and a weakly positive antinuclear antibody (titre 1 in 40). She was commenced on hydroxychloroquine 300 mg daily, which resulted in resolution of the panniculitis. She developed focal vitiligo on the thighs. This gradually improved with 0.1% mometasone furoate ointment. The hydroxychloroquine dose was tapered to 200 mg daily after 12 months, then to 100 mg daily after 18 months therapy. Her thyroid autoantibody levels continued to rise and the hydroxychloroquine was increased again to 300 mg daily. She became borderline hypothyroid. Hashimoto's thyroiditis was diagnosed. Thyroxine was instituted with a resultant improvement in her thyroid blood tests. The lipoatrophy has not developed further during 2‐year follow up.