Introduction:
Subcutaneous fat necrosis (SFN) is when fat cells die and become damaged, forming hard, painless lumps under the skin. It is often seen in newborns and is caused by various factors, including birth trauma, rapid cooling or heating of the skin, and medical conditions such as hypercalcemia or pancreatitis. Abrasion, on the other hand, is a type of wound that occurs when the skin is scraped or rubbed off. Again, various factors, including physical trauma, friction, or chemical exposure, can cause it.
Where Does Fat Necrosis Occur?
Fat necrosis can occur in any area of the body that has been damaged. However, the most common area affected is the breast, the most significant, most prominent, and most exposed fatty tissue quickly impacted by trauma, such as a seatbelt injury in a car accident or cancer treatments and procedures such as biopsy, radiation therapy, or surgery. Other fatty areas such as the abdomen, buttocks, and thighs can also be affected by medical or cosmetic procedures like tummy tucks or fat transfer procedures like Brazilian butt lifts (BBL).
In these procedures, the fat tissue may become damaged and necrotic, leading to the failure of the grafted tissue. In some severe cases of acute pancreatitis, fat necrosis can occur in the fatty tissue surrounding the pancreas. When pancreatic enzymes leak into the body and cause inflammation and irritation to the surrounding tissue, it can lead to pancreatic fat necrosis that usually affects the abdominal area but can sometimes spread throughout the body through the subcutaneous fat layer (panniculitis).
What Are the Possible Causes for Occurrence of Subcutaneous Fat Necrosis and Abrasion?
Subcutaneous fat necrosis (SFN) can be caused by several factors, including:
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Birth Trauma - SFN is a common condition in newborns and can be caused by the physical trauma of a difficult delivery. This trauma can damage the fat cells and lead to the formation of lumps.
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Rapid Cooling or Heating of the Skin - SFN can also be caused by rapid changes in skin temperature, such as from exposure to cold or hot water or from being placed in a cold or hot environment for an extended period.
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Medical Conditions - SFN can be a complication of medical conditions such as hypercalcemia, which is an elevated level of calcium in the blood, or pancreatitis, which is inflammation of the pancreas.
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Lipohypertrophy - It is the accumulation of fat in certain areas due to repeated insulin injections to treat diabetes. Fat accumulation in a single area can cause trauma to the fat cells and lead to SFN.
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Tumor Necrosis Factor (TNF) Inhibitors - TNF inhibitors are a medication used to treat autoimmune diseases such as rheumatoid arthritis. They have been known to cause SFN as a side effect.
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Trauma - Physical trauma, such as a blow to the body, can cause damage to the fat cells and lead to SFN.
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Inflammatory Conditions - Certain inflammatory conditions, such as lupus, can also cause SFN by causing damage to the fat cells.
What Are the Symptoms of Subcutaneous Fat Necrosis and Abrasion?
The primary symptom of subcutaneous fat necrosis (SFN) is the formation of complex, painless lumps under the skin. These lumps may or may not be tender and can develop anywhere on the body but are most commonly found on the legs, arms, and face. Other symptoms of SFN may include:
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Swelling -The affected area may become swollen due to the accumulation of fluid in the tissue.
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Discoloration - The skin of the affected area becomes red or discolored.
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Itching - Some individuals with SFN may experience itching in the affected area.
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Hypercalcemia - In some cases, SFN can also lead to high levels than-usual levels of calcium in the blood, which can cause additional symptoms such as fatigue, weakness, and frequent urination.
What Are the Complications of Subcutaneous Fat Necrosis and Abrasion?
Subcutaneous fat necrosis (SFN) can lead to the following complications:
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Calcium Deposits - Elevated calcium levels in the blood cause the formation of calcium deposits in various organs, including the heart, blood vessels, and kidneys.
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Infection - In some cases, the affected area may become infected, leading to additional symptoms such as pain, redness, and swelling.
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Formation of Cysts - Over time, the lumps caused by SFN can develop into cysts, which can be painful or cause discomfort.
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Scarring - In some cases, surgical removal of the lumps can result in scarring.
How to Diagnose Subcutaneous Fat Necrosis and Abrasion?
The diagnosis of subcutaneous fat necrosis (SFN) typically begins with a physical examination and a medical history review. The healthcare provider may ask about any recent trauma or changes in the temperature they may have experienced, as well as any underlying medical conditions. To confirm the diagnosis of SFN, the healthcare provider may order one or more of the following tests:
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Blood Tests- These detect elevated levels of calcium in the blood, which can be a sign of SFN.
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Ultrasound - An ultrasound can help visualize the affected area and determine the size and location of the lumps.
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Biopsy - A biopsy may be performed to examine the tissue under a microscope and confirm the diagnosis of SFN. Healthcare providers use many types of biopsy also to remove fat necrosis. A biopsy done for diagnosis may also remove the fat necrosis in some cases. Methods include:
- Fine Needle Aspiration -This method uses a needle which is a long, thin needle. The syringe can extract cells, tissue, and fluids. The needle can drain an oil cyst, which causes the lump to deflate.
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Vacuum-Assisted Core Needle Biopsy - This method uses a hollow needle to extract pieces of tissue through a small incision. Then, using ultrasound to help the needle. Doctors also attach a vacuum device to tissue through the chamber. This technique is similar to liposuction. This method requires local anesthesia.
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Excision Biopsy - A tissue is surgically removed. However, only some cases may require excision. Usually done if the lump is too big and cannot fit through a needle. This operation is done under local or general anesthesia.
What Is the Treatment of Subcutaneous Fat Necrosis and Abrasion?
The treatment for subcutaneous fat necrosis (SFN) will depend on the condition's underlying cause and the severity of the symptoms. Here are some standard treatment options:
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Pain Management - If the lumps are painful, over-the-counter pain relievers or prescription pain medication may be recommended.
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Drainage - In some cases, the affected area may need to be drained if it has become infected or if the fluid has accumulated in the tissue.
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Calcium Supplementation - If elevated levels of calcium in the blood are causing symptoms, the healthcare provider may recommend calcium supplementation to help regulate levels.
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Observation - If the lumps are small and not causing any symptoms, the healthcare provider may recommend monitoring the condition over time.
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Surgery - In some cases, surgery is necessary to remove the lumps if they are causing discomfort or affecting the quality of life.
Conclusion
SFN is not a contagious or infectious condition and can occur in individuals of any age and gender. Preventative measures for SFN include avoiding injury to the subcutaneous layer of the skin and seeking prompt medical attention in the event of a traumatic injury. It is essential to maintain a healthy lifestyle, including regular exercise and a balanced diet, which can also help reduce the risk of developing SFN and other related conditions. In conclusion, SFN is a condition that requires prompt medical attention and proper management to prevent the development of complications. Working closely with the healthcare provider ensures the best outcome and improved quality of life.
