Subacute Nodular Migratory Panniculitis (Vilanova Disease) Medication
- Author: Vlada Groysman, MD; Chief Editor: William D James, MD more...
Therapy for this condition is not mandatory, and several factors should be weighed prior to treatment. The factors that should be considered include the extent to which the disease disturbs the patient and the potential adverse effects of the medication.
Treatment with intralesional steroids may be effective. Otherwise, systemic medications, such as potassium iodide or dapsone, are used.
Potassium iodide is most commonly used therapy for this condition. It works via potassium concentration in granulomas, which releases heparin and inhibits delayed-type hypersensitivity response. Response should be seen in all patients in 2-3 weeks.
These agents may have immunomodulatory effects. Dapsone has been reported as being a successful treatment of subacute migratory panniculitis, but treatment is not well established.
Dapsone is bactericidal and bacteriostatic against mycobacteria; its mechanism of action is similar to that of sulfonamides, where competitive antagonists of PABA prevent formation of folic acid, inhibiting bacterial growth.
Triamcinolone decreases inflammation by suppressing migration of PMN leukocytes and reversing capillary permeability. Intralesional injections may be used for localized skin disorders.
Bafverstedt B. Not Available. Acta Derm Venereol. 1954. 34(3):181-93. [Medline].
Vilanova X, Pinol Aguade J. Subacute Nodular Migratory Panniculitis. Br J Dermatol. 1959 Feb. 71(2):45-50. [Medline].
de Almeida Prestes C, Winkelmann RK, Su WP. Septal granulomatous panniculitis: comparison of the pathology of erythema nodosum migrans (migratory panniculitis) and chronic erythema nodosum. J Am Acad Dermatol. 1990 Mar. 22(3):477-83. [Medline].
Fine RM, Meltzer HD. Chronic erythema nodosum. Arch Dermatol. 1969 Jul. 100(1):33-8. [Medline].
Sandoval M, Giesen L, Cataldo K, González S. Postirradiation Pseudosclerodermatous Panniculitis of the Leg: Report of a Case and Review of the Literature. Am J Dermatopathol. 2014 Jun 17. [Medline].
Lee UH, Yang JH, Chun DK, Choi JC. Erythema nodosum migrans. J Eur Acad Dermatol Venereol. 2005 Jul. 19(4):519-20. [Medline].
Ross M, White GM, Barr RJ. Erythematous plaque on the leg. Vilanova's disease (subacute nodular migratory panniculitis). Arch Dermatol. 1992 Dec. 128(12):1644-5, 1647. [Medline].
Rose C, Leverkus M, Fleischer M, Shimanovich I. Histopathology of panniculitis - aspects of biopsy techniques and difficulties in diagnosis. J Dtsch Dermatol Ges. 2011 Nov 16. [Medline].
Perry HO, Winkelmann RK. Subacute nodular migratory panniculitis. Arch Dermatol. 1964 Feb. 89:170-9. [Medline].
Schulz EJ, Whiting DA. Treatment of erythema nodosum and nodular vasculitis with potassium iodide. Br J Dermatol. 1976 Jan. 94(1):75-8. [Medline].
Sterling JB, Heymann WR. Potassium iodide in dermatology: a 19th century drug for the 21st century-uses, pharmacology, adverse effects, and contraindications. J Am Acad Dermatol. 2000 Oct. 43(4):691-7. [Medline].
Montgomery H, O'Leary P, Barker N. Nodular vascular diseases of the legs. JAMA. 1945. 128:335-41.
Lazaridou E, Apalla Z, Patsatsi A, Trigoni A, Ioannides D. Erythema nodosum migrans in a male patient with hepatitis B infection. Clin Exp Dermatol. 2009 Jun. 34(4):497-9. [Medline].