Subacute Nodular Migratory Panniculitis (Vilanova Disease)
- Author: Sarah B Sawyer, MD; Chief Editor: William D James, MD more...
Background
Vilanova disease, or subacute nodular migratory panniculitis, was first observed in 1954[1] and then named by Vilanova and Pinol Aguade in 1956.[2] Vilanova's original 14 patients were all women, most of whom were in their fifth decade of life. Since then, this condition has been diagnosed in men and women.
The nomenclature of this and related diseases is confusing, and some authors believe that Vilanova disease is merely a version of erythema nodosum because the histology is the same. The term chronic erythema nodosum is often used interchangeably with subacute nodular migratory panniculitis.[3, 4]
Pathophysiology
This is a disease of the subcutaneous septa and the blood vessels in the legs. This type of panniculitis exhibits greater septal thickening, granulomatous infiltration of the septa, and an absence of phlebitis. Although alpha1-antitrypsin deficiency, infectious etiology (streptococcal infection), and thyroid disease have been suggested, no specific etiologic agent has been found.
Epidemiology
Frequency
United States
Because of the ambiguity of this diagnosis versus other closely related conditions, no frequency has been determined.
Mortality/Morbidity
This condition has resulted in no mortality. It responds well to treatment, but recurrences are possible.
Race
No racial predilection is apparent.
Sex
It is more common in women than in men.[5]
Age
Vilanova disease has most frequently been reported in the third to sixth decades of life.
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. Feb 1959;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. Mar 1990;22(3):477-83. [Medline].
Fine RM, Meltzer HD. Chronic erythema nodosum. Arch Dermatol. Jul 1969;100(1):33-8. [Medline].
Lee UH, Yang JH, Chun DK, Choi JC. Erythema nodosum migrans. J Eur Acad Dermatol Venereol. Jul 2005;19(4):519-20. [Medline].
Requena L, Requena C. Erythema nodosum. Dermatol Online J. Jun 2002;8(1):4. [Medline]. [Full Text].
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].
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].
Perry HO, Winkelmann RK. Subacute nodular migratory panniculitis. Arch Dermatol. Feb 1964;89:170-9. [Medline].
Schulz EJ, Whiting DA. Treatment of erythema nodosum and nodular vasculitis with potassium iodide. Br J Dermatol. Jan 1976;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. Oct 2000;43(4):691-7. [Medline].
Montgomery H, O'Leary P, Barker N. Nodular vascular diseases of the legs. JAMA. 1945;128:335-41.
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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