Skin nontumor
Alpha-1-antitrypsin deficiency panniculitis

Author: Mowafak Hamodat, M.D., MB.CH.B, MSc., FRCPC (see Authors page)

Revised: 30 May 2017, last major update July 2011

Copyright: (c) 2002-2016,, Inc.

PubMed Search: Alpha-1-antitrypsin deficiency panniculitis

Cite this page: Alpha-1-antitrypsin deficiency panniculitis. website. Accessed July 16th, 2018.
Clinical features
  • Patients have low serum alpha-1-antitrypsin
  • Cutaneous lesions are diffuse indurated erythematous plaques or nodules that drain serosangineous fluid, on extensor surfaces of arms, legs, thighs, chest, back and abdomen
  • Also pulmonary effusion, embolism edema and anasarca
Case reports
Clinical images

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Ulcer on upper extremity

Microscopic (histologic) description
  • Early: diffuse neutrophilic infiltrate through dermis into subcutaneous septa, followed by destruction of collagen, reduction of inflammatory cells, detachment of lobules of fat from fibrous septa in a background of neutrophils
  • Draining lesions have channels lined by squamous epithelium
  • Late: extensive scarring of dermis and subcutis
Microscopic (histologic) images

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Lobular panniculitis with neutrophils

Positive stains
  • Immunoglobulin IgM and C3 may be found in blood vessel walls
Differential diagnosis
  • Bacterial cellulitis: infectious etiology