Nodular Fat Necrosis and Pancreatic Diseases

The occurrence of fat necrosis in the pancreas and surrounding omentum and mesentery is a well recognized syndrome, but fat necrosis involving areas distant to the pancreas appears to be more infrequent and less well recognized. Although nodular subcutaneous fat necrosis is described in medical literature as far back as 1889, it has never been mentioned in dermatologic textbooks.1,2 We have recently observed 5 acutely ill patients who had cutaneous nodules having a characteristic fat necrosis unlike that present in any disease involving the subcutaneous fat. In all 5 patients the acute illness was due to disease of the pancreas. The histologic picture of the cutaneous nodules was so uniformly characteristic that a diagnosis of pancreatic disease could be made without benefit of the case history and laboratory findings. In 2 of these cases the cutaneous nodules preceded the appearance of abdominal symptoms. Report of Cases Case 1.— A 57-year-old