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Subacute Nodular Migratory Panniculitis (Vilanova Disease) Clinical Presentation

  • Author: Vlada Groysman, MD; Chief Editor: William D James, MD  more...
Updated: Dec 15, 2014


Most commonly, patients describe a painless red nodule on the anterolateral aspect of the lower extremities that enlarges via centrifugal expansion or by the confluence of other nodules in proximity. Some nodules may exhibit central clearing with a morpheaform appearance. Usually, no trauma to the affected area is reported.

Some patients describe concurrent sore throat, fever, or arthralgias.



The examination typically reveals a unilateral, single, discrete, erythematous nodule or plaque on the anterolateral part of a lower extremity. The lesion displays peripheral extension, and the central portion may have a yellowish hue later in the course. A characteristic lack of ulceration of these lesions is noted. Over weeks or months, the nodules migrate (hence the name) and can become crescentic in nature.



Although this disease has been likened to erythema nodosum, the typical causative agents for classic erythema nodosum are not applicable to Vilanova disease. No obvious cause is apparent, but some reports document streptococcal infection in some patients.[8]

Contributor Information and Disclosures

Vlada Groysman, MD Medical Director, Cahaba Dermatology and Skin Health Center; Clinical Assistant Professor of Dermatology, University of Alabama at Birmingham School of Medicine

Vlada Groysman, MD is a member of the following medical societies: American Academy of Dermatology, Women's Dermatologic Society, Medical Dermatology Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Christen M Mowad, MD Professor, Department of Dermatology, Geisinger Medical Center

Christen M Mowad, MD is a member of the following medical societies: Alpha Omega Alpha, Noah Worcester Dermatological Society, Pennsylvania Academy of Dermatology, American Academy of Dermatology, Phi Beta Kappa

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Sungnack Lee, MD Vice President of Medical Affairs, Professor, Department of Dermatology, Ajou University School of Medicine, Korea

Sungnack Lee, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.


Daniel Davis, MD Associate Professor, Departments of Dermatology, Otolaryngology, and Pathology, University of Arkansas for Medical Sciences

Disclosure: Nothing to disclose.

Sarah B Sawyer, MD Dermatology and Laser of Alabama

Sarah B Sawyer, MD is a member of the following medical societies: American Academy of Cosmetic Surgery, American Academy of Dermatology, American Society for Dermatologic Surgery, and American Society for Laser Medicine and Surgery

Disclosure: Nothing to disclose.

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