Alpha-1 antitrypsin deficiency-associated panniculitis: a case report

Alpha-1 antitrypsin deficiency is a hereditary disorder with predominantly pulmonary but also extrapulmonary manifestations. In the skin, it is associated with panniculitis, a necrotizing neutrophilic inflammation in the subcutis. Clinically, it presents with tender, erythematous, oedematous, recurr...

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Main Authors: Špela But, Maja Jerše, Pij Bogomir Marko
Format: Article
Language:English
Published: Slovenian Medical Association 2025-06-01
Series:Zdravniški Vestnik
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Online Access:https://vestnik.szd.si/index.php/ZdravVest/article/view/3587
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author Špela But
Maja Jerše
Pij Bogomir Marko
author_facet Špela But
Maja Jerše
Pij Bogomir Marko
author_sort Špela But
collection DOAJ
description Alpha-1 antitrypsin deficiency is a hereditary disorder with predominantly pulmonary but also extrapulmonary manifestations. In the skin, it is associated with panniculitis, a necrotizing neutrophilic inflammation in the subcutis. Clinically, it presents with tender, erythematous, oedematous, recurrent, and potentially ulcerative nodules, most often located on the extremities or the trunk. The entity is often unrecognized, though it can greatly affect the patient’s quality of life and is potentially lethal. Clinical suspicion is supported by deep-skin biopsy, the concentration of alpha-1 antitrypsin in the serum, and electrophoresis, or, if possible, by genotype or phenotype characterization. Currently, the most widely accepted treatment options include dapsone, doxycycline, and augmentation therapy. We report a case of a young Caucasian man with alpha-1 antitrypsin deficiency that manifested with recurring and extremely painful nodules on his legs and gluteal area. The diagnosis was established based on the patient’s history, a low serum level of alpha-1 antitrypsin, and the findings of the deep-skin biopsy, which were suggestive of neutrophilic panniculitis. Total remission was achieved with dapsone, and the therapy was well-tolerated.
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spelling doaj-art-053b016e30e94903a826bd3eff0e63202025-08-20T03:28:58ZengSlovenian Medical AssociationZdravniški Vestnik1318-03471581-02242025-06-01945-614815410.6016/ZdravVestn.35873143Alpha-1 antitrypsin deficiency-associated panniculitis: a case reportŠpela But0Maja Jerše1Pij Bogomir Marko2Department of Dermatovenereology, University Medical Centre Ljubljana, Ljubljana, SloveniaInstitute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, SloveniaDepartment of Dermatology and Venereal Diseases, University Medical Centre Maribor, Maribor, SloveniaAlpha-1 antitrypsin deficiency is a hereditary disorder with predominantly pulmonary but also extrapulmonary manifestations. In the skin, it is associated with panniculitis, a necrotizing neutrophilic inflammation in the subcutis. Clinically, it presents with tender, erythematous, oedematous, recurrent, and potentially ulcerative nodules, most often located on the extremities or the trunk. The entity is often unrecognized, though it can greatly affect the patient’s quality of life and is potentially lethal. Clinical suspicion is supported by deep-skin biopsy, the concentration of alpha-1 antitrypsin in the serum, and electrophoresis, or, if possible, by genotype or phenotype characterization. Currently, the most widely accepted treatment options include dapsone, doxycycline, and augmentation therapy. We report a case of a young Caucasian man with alpha-1 antitrypsin deficiency that manifested with recurring and extremely painful nodules on his legs and gluteal area. The diagnosis was established based on the patient’s history, a low serum level of alpha-1 antitrypsin, and the findings of the deep-skin biopsy, which were suggestive of neutrophilic panniculitis. Total remission was achieved with dapsone, and the therapy was well-tolerated.https://vestnik.szd.si/index.php/ZdravVest/article/view/3587panniculitisneutrophilic panniculitisalpha-1 antitrypsinalpha-1 antitrypsin deficiencydapsone
spellingShingle Špela But
Maja Jerše
Pij Bogomir Marko
Alpha-1 antitrypsin deficiency-associated panniculitis: a case report
Zdravniški Vestnik
panniculitis
neutrophilic panniculitis
alpha-1 antitrypsin
alpha-1 antitrypsin deficiency
dapsone
title Alpha-1 antitrypsin deficiency-associated panniculitis: a case report
title_full Alpha-1 antitrypsin deficiency-associated panniculitis: a case report
title_fullStr Alpha-1 antitrypsin deficiency-associated panniculitis: a case report
title_full_unstemmed Alpha-1 antitrypsin deficiency-associated panniculitis: a case report
title_short Alpha-1 antitrypsin deficiency-associated panniculitis: a case report
title_sort alpha 1 antitrypsin deficiency associated panniculitis a case report
topic panniculitis
neutrophilic panniculitis
alpha-1 antitrypsin
alpha-1 antitrypsin deficiency
dapsone
url https://vestnik.szd.si/index.php/ZdravVest/article/view/3587
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AT pijbogomirmarko alpha1antitrypsindeficiencyassociatedpanniculitisacasereport