Pancreatic Panniculitis
- 4/9/2004
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Department Editor: Tania Phillips, MD, FRCPC
Overall Learning Objective: The physician or podiatrist participant will develop a rational approach to the evaluation and treatment of a variety of uncommon wounds and will have an increased awareness of the differential diagnosis of cutaneous wounds and the systemic diseases associated with these wounds.
Submissions: To submit a case for consideration in Diagnostic Dilemmas, e-mail or write to: Executive Editor, WOUNDS, 83 General Warren Blvd., Suite 100, Malvern, PA 19355, eklumpp@hmpcommunications.com
Completion Time: The estimated time to completion for this activity is 1 hour.
Target Audience: This CME/CPME activity is intended for dermatologists, surgeons, podiatrists, internists, and other physicians who treat wounds.
At the conclusion of this activity, the participant should be able to:
1) Generate a differential diagnosis when panniculitis is suspected
2) Describe and discuss illnesses that are associated with pancreatic panniculitis
3) Describe and discuss the management of a patient with pancreatic panniculitis.
Disclosure: All faculty participating in Continuing Medical Education programs sponsored by HMP Communications are expected to disclose to the program audience any real or apparent conflict(s) of interest related to the content of their presentation. Drs. Federman, McNiff, and Kirsner disclose that they have no financial conflicts relevant to the content of this activity.
Accreditation: HMP Communications is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. HMP Communications is approved by the Council on Podiatric Medical Education as a sponsor of continuing education in podiatric medicine.
Designation: HMP Communications designates this continuing medical education activity for 1 credit hour in Category 1 of the Physician’s Recognition Award of the American Medical Association. Each physician should claim only those hours he/she spent in the educational activity. HMP Communications designates this continuing medical activity for .1 CEUs available to participating podiatrists.
Method of Participation: Participants must read the article and take, submit, and pass the post-test by April 15, 2005. Participants must completely fill out the answer and evaluation form, answer at least 70 percent of the questions correctly, and mail or fax the answer/evaluation forms to:
Trish Levy, CME Director, HMP Communications, Suite 100,
83 General Warren Blvd., Malvern, PA 19355
Fax (610) 560-0501
This activity has been planned and produced in accordance with the ACCME Essential Areas and Policies.
Release date: April 15, 2004
Expiration date: April 15, 2005
Presentation
A 67-year-old man was admitted to the hospital after complaining of painful lower-extremity ulcers and two days of fever. One month prior to admission, he developed a raised, red, nodular lesion on his right lateral foot and over the next few weeks developed multiple other similar lesions on his lower extremities and forearms, as well as painful bilateral lower-extremity swelling. He was recently treated with a course of antibiotics for presumed cellulitis of his lower extremities at another facility without improvement. During that time, he complained of diffuse abdominal pain and a 20-pound weight loss. A computerized tomography (CT) scan was obtained and revealed a pancreatic mass; a subsequent biopsy performed during upper endoscopy with ultrasound guidance was reportedly negative for malignancy.
His past medical history was significant for a remote history of alcohol abuse, hypertension, and peripheral vascular disease. His surgical history included a left femoral-popliteal lower-extremity bypass procedure six years before presentation and repair of a cerebral aneurysm 11 years prior to presentation.
References
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13. Cubilla AL, Fitzgerald PJ. Tumors of the exocrine pancreas. Atlas of Tumor Pathology, Second Series. Fascicle 19. Washington, D.C: Armed Forces Institute of Pathology, 1984.
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