Practice Essentials
Vilanova disease, or subacute nodular migratory panniculitis, was first observed in 1954 [1] and then named by Vilanova and Pinol Aguade in 1956. [2] Vilanova's original 14 patients were all women, most of whom were in their fifth decade of life. Since then, this condition has been diagnosed in men and women.
The nomenclature of this and related diseases is confusing, and some authors believe that Vilanova disease is merely a version of erythema nodosum because the histology is the same. The terms chronic erythema nodosum and erythema nodosum migrans are often used interchangeably with subacute nodular migratory panniculitis. [3, 4, 5, 6, 7]
Prognosis
The prognosis for this condition is good. It typically responds to treatment. However, the condition often recurs. This condition has resulted in no mortality.
Patient education
Patients should be informed that the risks of treatment of this condition might outweigh the benefits. The decision to treat should be on an individual basis.
Complications
Koebnerization to plaque psoriasis has been reported. [8]
Diagnostics
A chest radiograph should be obtained to rule out sarcoidosis and tuberculosis.
A skin biopsy is necessary to make the diagnosis. [9]
Also see Workup.
Treatment
See Medical Care.
Consultations
Consult a dermatologist to perform a skin biopsy.
Background
Pathophysiology
This is a disease of the subcutaneous septa and the blood vessels in the legs. [10] This type of panniculitis exhibits greater septal thickening, granulomatous infiltration of the septa, and an absence of phlebitis. Although alpha1-antitrypsin deficiency, infectious etiology (streptococcal infection), and thyroid disease have been suggested, no specific etiologic agent has been found.
Epidemiology
Because of the ambiguity of this diagnosis versus other closely related conditions, no frequency has been determined.
No racial predilection is apparent, but it is more common in women than in men. [11]
Vilanova disease has most frequently been reported in the third to sixth decades of life.
