In the Rothmann-Makai type, the nodules are small
and multiple and seem to be self-limited with no severe systemic
involvement. Histologically, the lesions are most marked in the fat. There
are dermal changes with foci of small round cells and macrophages around
blood vessels and appendages. Presence of granulomata composed of
macrophages, fibroblasts, multinucleate cells, and polymorphs. There is absence of
caseation. The panniculitis is an inflammation of subcutaneous fat responsible for
fairly uniform clinical features including nodules and plaques, or swelling
located in the subcutaneous tissue, occasionally progressing to atrophy of
subcutaneous fat. The hypothesis of an abnormal fragility of adipose tissue
or of a failure in the mechanisms of protection against lipophagia has been
raised.