Skin-nontumor / Clinical dermatology
Other dermatoses
Alpha-1-antitrypsin deficiency panniculitis

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

Revised: 22 June 2016, last major update July 2011

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PubMed Search: Alpha-1-antitrypsin deficiency panniculitis

Cite this page: Alpha-1-antitrypsin deficiency panniculitis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/skinnontumora1antitrypsin.html. Accessed December 8th, 2016.
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

Micro 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
Micro 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