Sjögren syndrome is characterized by lymphocytic infiltrates in exocrine organs. Patients present with xerophthalmia, xerostomia, and parotid gland enlargement. Sjögren syndrome is associated with an uncommon but distinctive form of panniculitis. We present a case of a woman who developed a lobular granulomatous panniculitis associated with Sjögren syndrome.
A 68-year-old woman presented with a 6-week history of tender, indurated nodules and plaques on the bilateral extensor forearms and right leg. The lesions started as pea-sized papules and enlarged to swollen, hot, tender plaques. She denied pruritus, trauma, or new medications. A 5-day course of cephalexin for presumed cellulitis followed by a 1-week taper of prednisone provided no relief. Medical history included hypothyroidism, diabetes, migraines, and endometrial cancer. Family history was significant for a sister with rheumatoid arthritis. Review of systems revealed malaise, dry eyes, dry mouth, joint aches, and dull muscle pains.