Panniculitis following steroid therapy.

A 10-year-old child experienced painful nodular lesions following rapid withdrawal of large doses of orally-administered prednisolone prescribed for treatment of an episode of hepatic encephalopathy. Histopathologic examination of a nodule revealed extensive fat necrosis, needle-shaped clefts within fat cells, and marked nonspecific granulomatous infiltrate that spared the interlobular septa. The lesions subsided completely in about four weeks without any treatment, leaving only residual hyperpigmentation.