Subacute Nodular Migratory Panniculitis (Vilanova Disease) Medication

  • Author: Sarah B Sawyer, MD; Chief Editor: William D James, MD   more...
 
Updated: Jan 19, 2012
 

Medication Summary

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.

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Iodine products

Class Summary

Treatment with intralesional steroids may be effective. Otherwise, systemic medications, such as potassium iodide or dapsone, are used.

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Potassium iodide (SSKI, Pima)

 

Most commonly used therapy for this condition. 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 wk.

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Leprostatic agents

Class Summary

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.

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Dapsone (Avlosulfon)

 

Bactericidal and bacteriostatic against mycobacteria; mechanism of action is similar to that of sulfonamides where competitive antagonists of PABA prevent formation of folic acid, inhibiting bacterial growth.

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Triamcinolone (Aristocort, Aristospan)

 

Decreases inflammation by suppressing migration of PMN leukocytes and reversing capillary permeability. Intralesional injections may be used for localized skin disorder.

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Contributor Information and Disclosures
Author

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.

Coauthor(s)

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

Disclosure: Nothing to disclose.

Vlada Groysman, MD  Staff Physician, Department of Dermatology, University of Alabama School of Medicine

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

Disclosure: Nothing to disclose.

Specialty Editor Board

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 Dermatological Association

Disclosure: Nothing to disclose.

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, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

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

Christen M Mowad, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

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 and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

References

  1. Bafverstedt B. Not Available. Acta Derm Venereol. 1954;34(3):181-93. [Medline].

  2. Vilanova X, Pinol Aguade J. Subacute Nodular Migratory Panniculitis. Br J Dermatol. Feb 1959;71(2):45-50. [Medline].

  3. 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. Mar 1990;22(3):477-83. [Medline].

  4. Fine RM, Meltzer HD. Chronic erythema nodosum. Arch Dermatol. Jul 1969;100(1):33-8. [Medline].

  5. Lee UH, Yang JH, Chun DK, Choi JC. Erythema nodosum migrans. J Eur Acad Dermatol Venereol. Jul 2005;19(4):519-20. [Medline].

  6. Requena L, Requena C. Erythema nodosum. Dermatol Online J. Jun 2002;8(1):4. [Medline]. [Full Text].

  7. Ross M, White GM, Barr RJ. Erythematous plaque on the leg. Vilanova's disease (subacute nodular migratory panniculitis). Arch Dermatol. Dec 1992;128(12):1644-5, 1647. [Medline].

  8. Rose C, Leverkus M, Fleischer M, Shimanovich I. Histopathology of panniculitis - aspects of biopsy techniques and difficulties in diagnosis. J Dtsch Dermatol Ges. Nov 16 2011;[Medline].

  9. Perry HO, Winkelmann RK. Subacute nodular migratory panniculitis. Arch Dermatol. Feb 1964;89:170-9. [Medline].

  10. Schulz EJ, Whiting DA. Treatment of erythema nodosum and nodular vasculitis with potassium iodide. Br J Dermatol. Jan 1976;94(1):75-8. [Medline].

  11. 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. Oct 2000;43(4):691-7. [Medline].

  12. Montgomery H, O'Leary P, Barker N. Nodular vascular diseases of the legs. JAMA. 1945;128:335-41.

  13. Niemi KM, Forstrom L, Hannuksela M, Mustakallio KK, Salo OP. Nodules on the legs. A clinical, histological and immunohistological study of 82 patients representing different types of nodular panniculitis. Acta Derm Venereol. 1977;57(2):145-54. [Medline].

 
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