Septal Panniculitis

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 12 min read
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Septal panniculitis is a term used to describe a group of skin conditions that involve inflammation of the subcutaneous fat and connective tissue in the nasal septum. The nasal septum is the partition that separates the left and right nasal cavities and is composed of...

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বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

এই তথ্য শিক্ষা ও সচেতনতার জন্য। এটি ডাক্তারি পরীক্ষা, রোগ নির্ণয় বা প্রেসক্রিপশনের বিকল্প নয়।

Article Summary

Septal panniculitis is a term used to describe a group of skin conditions that involve inflammation of the subcutaneous fat and connective tissue in the nasal septum. The nasal septum is the partition that separates the left and right nasal cavities and is composed of cartilage, bone, and soft tissue. Septal panniculitis can lead to changes in the normal anatomy of the nasal septum, causing...

Key Takeaways

  • This article explains Causes in simple medical language.
  • This article explains Symptoms in simple medical language.
  • This article explains Diagnosis in simple medical language.
  • This article explains Treatment in simple medical language.
Educational health guideWritten for patient understanding and clinical awareness.
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Definition

Septal panniculitis is a term used to describe a group of skin conditions that involve infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation of the subcutaneous fat and connective tissue in the nasal septum. The nasal septum is the partition that separates the left and right nasal cavities and is composed of cartilage, bone, and soft tissue. Septal panniculitis can lead to changes in the normal anatomy of the nasal septum, causing functional and cosmetic issues.

There are several types of septal panniculitis, each with its unique set of symptoms and causes. Here is a list of the most common types of septal panniculitis:

  1. Wegener’s granulomatosis (WG)
  2. Necrobiotic xanthogranuloma (NXG)
  3. Rosai-Dorfman disease (RDD)
  4. Rheumatoid nodules
  5. Tufted angioma (TA)
  6. SAPHO syndrome
  7. IgG4-related disease
  8. Wegener’s granulomatosis (WG): Wegener’s granulomatosis is a rare autoimmune disease that affects the blood vessels and causes infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation in various organs, including the skin and nasal septum. In WG, the immune system mistakenly attacks the body’s own tissues, leading to the formation of granulomas (clumps of immune cells) in the affected areas. In the nasal septum, granulomas can cause panniculitis, leading to septal perforation and nasal obstruction. Other symptoms of WG include sinusitis, ear infections, joint pain, and respiratory problems.
  9. Necrobiotic xanthogranuloma (NXG): Necrobiotic xanthogranuloma is a rare skin condition that is characterized by yellowish-orange papules and nodules that typically affect the face, eyelids, and ears. In some cases, the nasal septum may also be affected, leading to septal panniculitis. NXG is associated with elevated levels of a protein called paraprotein, which can be found in the blood and urine of affected individuals. The exact cause of NXG is unknown, but it is thought to be related to an autoimmune process.
  10. Rosai-Dorfman disease (RDD): Rosai-Dorfman disease is a rare condition that is characterized by the accumulation of abnormal cells in the lymph nodes and other tissues, including the skin. In some cases, the nasal septum can be affected, leading to septal panniculitis. RDD is usually asymptomatic, but in some cases, it can cause skin lesions, fever, and enlarged lymph nodes. The exact cause of RDD is unknown, but it is thought to be related to an abnormal immune response.
  11. Rheumatoid nodules: Rheumatoid nodules are firm, round lumps that form under the skin in people with pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।" data-rx-term="arthritis" data-rx-definition="Arthritis means joint inflammation causing pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।">arthritis: Rheumatoid arthritis is an autoimmune joint disease causing infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation, pain, and swelling. সহজ বাংলা: রোগপ্রতিরোধ ব্যবস্থার ভুল আক্রমণে জয়েন্টের প্রদাহ।" data-rx-term="rheumatoid arthritis" data-rx-definition="Rheumatoid arthritis is an autoimmune joint disease causing inflammation, pain, and swelling. সহজ বাংলা: রোগপ্রতিরোধ ব্যবস্থার ভুল আক্রমণে জয়েন্টের প্রদাহ।">rheumatoid arthritis (RA). In some cases, these nodules can also develop in the nasal septum, leading to septal panniculitis. Rheumatoid nodules are caused by the abnormal accumulation of immune cells in the affected areas and are thought to be a result of the chronic inflammation that occurs in RA.
  12. Tufted angioma (TA): Tufted angioma is a rare benign vascular tumor that typically affects children and young adults. It is characterized by the presence of red or purple papules or nodules that

Causes

The exact cause of septal panniculitis is not well understood, but there are a number of factors that have been identified as contributing to its development. Here is a list of potential causes for septal panniculitis:

  1. Trauma: Physical trauma to the nose, such as a broken nose or repeated blunt force injuries, can cause infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation and chronic injury or inflammation. সহজ বাংলা: অতিরিক্ত দাগের মতো টিস্যু তৈরি হওয়া।" data-rx-term="fibrosis" data-rx-definition="Fibrosis means excess scar-like tissue formation after chronic injury or inflammation. সহজ বাংলা: অতিরিক্ত দাগের মতো টিস্যু তৈরি হওয়া।">fibrosis of the septal tissues.
  2. Infection: Bacterial, viral, or fungal infections can cause pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation and thickening of the septal tissues, leading to septal panniculitis.
  3. Allergic reactions: Allergic reactions to substances such as pollen, dust mites, or animal dander can cause inflammation and fibrosis of the septal tissues.
  4. Autoimmune disorders: Autoimmune disorders, such as lupus or rheumatoid arthritis, can cause inflammation and fibrosis of the septal tissues.
  5. Immune system disorders: Disorders of the immune system, such as HIV or AIDS, can cause inflammation and fibrosis of the septal tissues.
  6. Medications: Certain medications, such as steroids or chemotherapy drugs, can cause inflammation and fibrosis of the septal tissues.
  7. Exposure to environmental toxins: Exposure to environmental toxins, such as tobacco smoke or air pollution, can cause inflammation and fibrosis of the septal tissues.
  8. Genetics: Some people may have a genetic predisposition to septal panniculitis, which can be triggered by environmental factors.
  9. Nutritional deficiencies: Nutritional deficiencies, such as a lack of vitamin C or zinc, can weaken the tissues and make them more susceptible to inflammation and fibrosis.
  10. Hormonal imbalances: Hormonal imbalances, such as hypothyroidism or menopause, can cause inflammation and fibrosis of the septal tissues.
  11. Stress: Chronic stress can weaken the tissues and make them more susceptible to inflammation and fibrosis.
  12. Alcohol consumption: Heavy alcohol consumption can cause inflammation and fibrosis of the septal tissues.
  13. Smoking: Smoking can cause inflammation and fibrosis of the septal tissues due to the exposure to toxic chemicals in tobacco smoke.
  14. Poor hygiene: Poor hygiene, such as not washing the nose regularly, can allow bacteria and other pathogens to flourish, leading to infection and inflammation.
  15. Dehydration: Dehydration can cause the tissues to become dry and brittle, making them more susceptible to injury and inflammation.
  16. Sun exposure: Excessive sun exposure can cause damage to the tissues and make them more susceptible to inflammation and fibrosis.
  17. Poor posture: Poor posture, such as slouching or hunching over, can put pressure on the tissues of the nose and cause injury and inflammation.
  18. Aging: The tissues of the nose naturally weaken and become more susceptible to injury and inflammation as we age.
  19. Hormonal changes during pregnancy: Hormonal changes during pregnancy can cause the tissues of the nose to become more susceptible to injury and inflammation.
  20. Rhinitis medicamentosa: Chronic use of over-the-counter decongestant nasal sprays can cause rebound congestion and inflammation of the septal tissues.

Symptoms

Symptoms associated with septal panniculitis:

  1. Painful lumps or nodules in the nasal septum: The primary symptom of septal panniculitis is the formation of painful lumps or nodules in the nasal septum. These lumps may be red, inflamed, and tender to the touch.
  2. Swelling: The lumps in the nasal septum can cause swelling in the affected area.
  3. Nasal obstruction: The swelling and lumps in the nasal septum can obstruct the airflow through the nose, making it difficult to breathe.
  4. Discharge: Some patients may experience a discharge from the affected area.
  5. Itching: The lumps or nodules in the nasal septum can be itchy.
  6. Headache: The inflammation and swelling in the nasal septum can cause headache.
  7. Fatigue: Some patients may experience fatigue as a result of the pain and discomfort associated with septal panniculitis.
  8. Loss of appetite: The pain and discomfort associated with septal panniculitis can lead to a loss of appetite.
  9. Weight loss: The loss of appetite can result in weight loss.
  10. Nausea: Some patients may experience nausea as a result of the pain and discomfort associated with septal panniculitis.
  11. Vomiting: Some patients may experience vomiting as a result of the pain and discomfort associated with septal panniculitis.
  12. Fever: In some cases, septal panniculitis can cause a low-grade fever.
  13. Night sweats: Some patients may experience night sweats as a result of the inflammation and swelling associated with septal panniculitis.
  14. Chills: Some patients may experience chills as a result of the inflammation and swelling associated with septal panniculitis.
  15. Muscle aches: Some patients may experience muscle aches as a result of the pain and discomfort associated with septal panniculitis.
  16. Joint pain: Some patients may experience joint pain as a result of the inflammation and swelling associated with septal panniculitis.
  17. Skin rash: Some patients may develop a skin rash in the affected area.
  18. Redness: The affected area may be red due to the inflammation and swelling associated with septal panniculitis.
  19. Warmth: The affected area may feel warm to the touch due to the inflammation and swelling associated with septal panniculitis.
  20. Scarring: In some cases, the lumps or nodules in the nasal septum can cause scarring.

It is important to note that not all patients with septal panniculitis will experience all of these symptoms. The severity and specific symptoms experienced can vary greatly from one patient to another.

Diagnosis

Here is a list of diagnosis and tests for septal panniculitis:

  1. Clinical examination: The first and foremost step in diagnosing septal panniculitis is a thorough clinical examination of the affected area by a dermatologist or a specialist. The examination includes observing the appearance, size, and location of the nodules or plaques, and assessing the extent of the involvement of the septal fat.
  2. Biopsy: A biopsy is the removal of a small sample of skin or tissue for examination under a microscope. It is an important diagnostic tool for septal panniculitis and is used to confirm the diagnosis and rule out other skin conditions.
  3. Hormonal evaluation: Hormonal imbalances can sometimes be a contributing factor in the development of septal panniculitis, and a hormonal evaluation may be performed to determine if hormonal therapy is necessary.
  4. Blood tests: Blood tests are used to evaluate the patient’s overall health and to rule out any underlying medical conditions that may be contributing to the development of septal panniculitis. These tests may include complete blood count (CBC), erythrocyte sedimentation rate (ESR), and c-reactive protein (CRP).
  5. Rheumatologic tests: Rheumatologic tests are used to evaluate the patient’s immune system and to rule out any underlying autoimmune diseases that may be contributing to the development of septal panniculitis. These tests may include antinuclear antibody (ANA) test, anti-dsDNA antibody test, and rheumatoid factor (RF) test.
  6. Infectious disease tests: Infectious diseases can sometimes be a contributing factor in the development of septal panniculitis, and tests may be performed to rule out any underlying infections. These tests may include blood culture, tuberculosis skin test, and hepatitis B and C serology.
  7. Computed tomography (CT) scan: A CT scan is a type of X-ray that produces detailed images of the body’s internal structures. It is used to evaluate the extent of involvement of the septal fat and to rule out any underlying medical conditions that may be contributing to the development of septal panniculitis.
  8. Magnetic resonance imaging (MRI) scan: An MRI scan is a type of imaging test that uses strong magnetic fields and radio waves to produce detailed images of the body’s internal structures. It is used to evaluate the extent of involvement of the septal fat and to rule out any underlying medical conditions that may be contributing to the development of septal panniculitis.
  9. Ultrasound: Ultrasound is a type of imaging test that uses high-frequency sound waves to produce images of the body’s internal structures. It is used to evaluate the extent of involvement of the septal fat and to rule out any underlying medical conditions that may be contributing to the development of septal panniculitis.

Treatment

Diagnoses and tests can be used to diagnose and evaluate septal panniculitis.

  1. Physical Examination: A physical examination is the first step in diagnosing septal panniculitis. During this examination, the healthcare provider will look for signs of swelling, redness, and tenderness in the nose.
  2. Nasal Endoscopy: A nasal endoscopy is a procedure in which a thin, flexible tube with a light and camera is inserted into the nose to visualize the interior of the nasal passages. This test can help the healthcare provider to identify any abnormalities in the septal fat pads, such as swelling or inflammation.
  3. CT Scan: A CT scan is a type of X-ray that uses computer technology to produce detailed images of the body. This test can help to visualize the septal fat pads and any other structural abnormalities in the nose.
  4. MRI Scan: An MRI scan uses a strong magnetic field and radio waves to produce images of the body. This test can help to identify any structural abnormalities in the septal fat pads and to evaluate the extent of inflammation.
  5. Biopsy: A biopsy is a procedure in which a small piece of tissue is removed from the affected area for examination under a microscope. This test can help to determine the cause of the inflammation and to rule out other medical conditions.
  6. Allergy Testing: Allergy testing can be used to determine if allergies are contributing to the development of septal panniculitis. This can be done through skin prick tests or blood tests.
  7. Complete Blood Count (CBC): A CBC is a blood test that measures the number of red and white blood cells in the blood. This test can help to determine if there is an underlying infection or autoimmune disorder contributing to the development of septal panniculitis.
  8. Erythrocyte Sedimentation Rate (ESR): The ESR test measures the rate at which red blood cells settle to the bottom of a test tube. This test can help to determine if there is inflammation in the body.
  9. C-Reactive Protein (CRP) Test: The CRP test measures the level of CRP in the blood. CRP is a protein produced by the liver in response to inflammation. This test can help to determine the extent of inflammation in the body.
  10. Rheumatoid Factor (RF) Test: The RF test measures the level of RF in the blood. RF is an antibody produced by the immune system in response to inflammation. This test can help to determine if there is an underlying autoimmune disorder contributing to the development of septal panniculitis.
  11. Antinuclear Antibody (ANA) Test: The ANA test measures the level of ANA in the blood. ANA is an antibody produced by the immune system in response to inflammation. This test can help to determine if there is an underlying autoimmune disorder contributing to the development of septal panniculitis.
  12. HLA-B27 Test: The HLA-B27 test is a genetic test that can help to determine if a person is at increased risk for developing certain


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A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Avoid heavy lifting, sudden bending, and prolonged bed rest.
  • Use comfortable posture and gentle movement as tolerated.
  • Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

  • For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
  • Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

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Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Medicine doctor / pediatrician for children / qualified clinician
Tests to discuss with doctor
  • Temperature chart and hydration assessment
  • CBC with platelet count if fever persists or dengue/other infection is possible
  • Urine test, malaria/dengue tests, chest evaluation, or blood culture only when clinically indicated
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?
  • Do I need antibiotics, or is this more likely viral?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Septal Panniculitis

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

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Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

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  10. Complete Endocardial Cushion Defect

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    February 28, 2026 • Rx Autoimmune, Genetic and Rare Diseases (A - Z)