Panniculitis as the first manifestation of systemic lupus erythematosus: description of two cases.

Two patients are described in whom panniculitis proved to be the first symptom of the disease systemic lupus erythematosus (SLE). Histological examination of a painless solitary cutaneous lesion in the otherwise asymptomatic first patient showed a nonspecific nodular panniculitis; 1 yr later a definite diagnosis of SLE was made. In the second patient panniculitis had the clinical appearance of erythema nodosum and was one of several presenting symptoms of SLE. These patients were part of a group of 68 newly diagnosed patients with SLE, indicating a 3% prevalence of panniculitis in SLE. These cases illustrate that SLE should always be considered as an underlying disease in young female patients presenting with nodular panniculitis, which may mimic the clinical picture of erythema nodosum.