TY - JOUR T1 - Case number 31: Nodular panniculitis as expression of Munchausen’s syndrome (panniculitis artefacta) JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 1195 LP - 1196 DO - 10.1136/ard.2004.024539 VL - 63 IS - 10 AU - A-K Tausche AU - S Hänsel AU - K Tausche AU - S Unger AU - H E Schröder AU - J Pietsch Y1 - 2004/10/01 UR - http://ard.bmj.com/content/63/10/1195.abstract N2 - A 45 year old woman presented with a 4 year history of fever attacks, generalised fatigue, arthralgias, and recurring painful nodules of the subcutaneous tissue in different localisations. Extensive diagnostic procedures had been carried out in several rheumatological and dermatological departments of university hospitals (13 admissions). Under the diagnosis of nodular panniculitis and because of the deep infiltration, incisions and surgical debridement were often necessary. At the physical examination she had a temperature over 39°C, an approximately plum sized painful nodule in the subcutaneous tissue of the left shoulder, and ulcerations of the left hand and elbow (after surgical debridement) (fig 1⇓). Figure 1  Painful deep nodule—left shoulder.Laboratory tests showed a raised white cell count of 11.6×10 … ER -