Postirradiation pseudosclerodermatous panniculitis (PIPP) is an extremely rare complication of radiation characterized by a delayed inflammatory process involving the subcutaneous fat. Clinically, it presents as an erythematous, indurated plaque or subcutaneous nodule at a previously radiated anatomic site and could mimic recurrence of the malignancy. PIPP can occur months to years after radiation. The chest wall is the most common site, usually following radiation for breast cancer. Extrathoracic locations such as the leg, due to radiation therapy for Kaposi sarcoma and liposarcoma, have also been reported. Women are predominantly affected.