June 19-20, 2017 Philadelphia, USA
International Conference on
Clinical and Experimental Dermatology
Volume 8, Issue 4 (Suppl)
J Clin Exp Dermatol Res, an open access journal
June 19-20, 2017
Vancomycin induced panniculitis: A rare drug reaction
Emily Shao, Sarath Bodapati, Andrew Freeman
Royal Brisbane and Women’s Hospital, Australia
Panniculitis is an uncommon condition that typically presents as a non-specific area of erythema, with deep-
seated nodules and plaques. There are a number of aetiologies the cause panniculitis, including infection, auto-immune,
traumatic, and drug-induced. To our knowledge there have been no published cases of vancomycin-induced panniculitis.
A 57-year-old Indigenous-Australian woman presented with a 1-month history of painful subcutaneous nodules.
This coincided with commencement of vancomycin for treatment of bacteremia secondary to osteomyelitis. There were no
other new medications started. On examination there were tender, firm subcutaneous nodules to the left anterior chest,
bilateral flank, and back, with widespread eczematous plaques to the back. She reported a similar episode onset of development
of a subcutaneous nodule 2 years ago, also after starting vancomycin. Histopathology showed eosinophilic panniculitis with
dermal reaction containing frequent eosinophils. There was no histological support for either lupus or infective causes. She had
a complex medical background, including type two diabetes, obesity, chronic obstructive pulmonary disease, ischemic heart
disease, dyslipidaemia, osteoarthritis, pseudoseizures, atrial fibrillation, rheumatic heart disease and subsequent infectious
endocarditis, requiring a mitral valve replacement.
This is the first case of panniculitis associated with vancomycin that we have found in the literature. Medications
that have been associated with panniculitis include but is not limited to leukotriene modifying agents, interferon beta therapy,
potassium bromide, protease inhibitors, glatiramir acetate and corticosteroid withdrawal.
Panniculitis is associated with a wide range of aetiologies. Drug induced panniculitis and the mechanisms behind
it are poorly understood, and features are often indistinguishable from other causes. In patients who present with panniculitis,
clinicians should maintain a degree of suspicion for an adverse drug reaction, as there is a wide range of medications that can
Emily Shao has graduated from the University of Queensland with a BSc/MBBS in 2015. She is currently working at the Royal Brisbane and Women’s Hospital as
an Intern and is completing a Master of Public Health at the University of Sydney. As an aspiring Dermatologist, she is actively involved with dermatology-related
Emily Shao et al., J Clin Exp Dermatol Res 2017, 8:4 (Suppl)