A63-year-oldwomanpresentedtotheoutpatientprimaryclinicwithtendererythematousnodulesandulcersdrainingoilybrownmaterialonbilaterallowerextremities.（A）
Hermedicalhistorywasnotableforanepisodeofpancreatitisandpancreaticpseudocyst,4yearsago.Thelesionsappearedaweekagoandprogressedfromareasoferythematousmaculestotendernodulesandfewevolvedintoulcersdraininganoilybrownmaterial.（B）Atthetimeofpresentation,shealsohadnauseaandmildabdominalpain.Physicalexaminationwasremarkableforskinchangesandmildabdominaltenderness.
Onlaboratoryinvestigations,serumamylaseandlipaselevelswereandU/L,respectively.CTscanshowedenlargedpancreaticductmeasuring7mmwithunchangedcysticmassupto1.6cmintheuncinateprocesswithmildpancreaticinflammation.Shewasadmittedtothehospitalformanagementofacutepancreatitiswithintravenousfluidsandpainmedications.Biopsyoftheskinlesionsrevealedlobularpanniculitiswithoutvasculitis,necrosisofadipocyteswithformationof‘ghostadipocytes’(enucleatedcellsaftercoagulationnecrosis)andcalciumdeposition,pathognomonicforpancreaticpanniculitis.
Shewasdischargedfromhospital,herlesions
