Subacute Nodular Migratory Panniculitis (Vilanova Disease) Clinical Presentation

Updated: Apr 17, 2017
  • Author: Dirk M Elston, MD; Chief Editor: William D James, MD  more...
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Presentation

History

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.

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Physical Examination

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.

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Causes

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. [9]

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