Lipomatous metaplasia after severe and chronic cutaneous inflammation

A 69-year-old woman with a history of acute generalized exanthematic pustulosis (AGEP) caused by metamizole is described. Furthermore, she had suffered from an untreated psoriasis since the age of 20. After an adequate therapy of both psoriasis and AGEP, yellow-brownish, static, coalescing, lucent nodules on the thighs and upper arms became apparent. Histology of skin biopsies revealed a prominent band of mature adipocytes in the dermis. We diagnosed a lipomatous metaplasia of the dermis and hypothesize that this metaplasia occurred as a consequence of the severe and chronic inflammation of the skin.