This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Paradela, S Articles by Fonseca, E Search for Related Content PubMed PubMed Citation Articles by Paradela, S Articles by Fonseca, E Pubmed/NCBI databases Medline Plus Health Information Lupus Social Bookmarking                         What's this?

Interface dermatitis in skin lesions of Kikuchi–Fujimoto’s disease: a histopathological marker of evolution into systemic lupus erythematosus?

Department of Dermatology, Hospital Juan Canalejo, La Coruña, Spain

J Lorenzo

Department of Internal Medicine, Hospital Juan Canalejo, La Coruña, Spain

W Martínez-Gómez

Department of Dermatology, Hospital Juan Canalejo, La Coruña, Spain

T Yebra-Pimentel

Department of Pathology, Hospital Juan Canalejo, La Coruña, Spain

L Valbuena

Department of Pathology, Hospital Juan Canalejo, La Coruña, Spain

E Fonseca

Department of Dermatology, Hospital Juan Canalejo, La Coruña, Spain

Kikuchi’s disease (KD) is a self-limiting histiocytic necrotizing lymphadenitis (HNL). Cutaneous manifestations are frequent and usually show histopathological findings similar to those observed in the involved lymph nodes. HNL with superposed histological features to KD has been described in patients with lupus erythematosus (LE), and a group of healthy patients previously reported as having HNL may evolve into LE after several months. Up to date, features to predict which HNL patients will have a self-limiting disease and which could develop LE have been not identified. In order to clarify the characteristics of skin lesions associated with KD, we report a case of HNL with evolution into systemic lupus erythematosus (SLE) and a review of previous reports of KD with cutaneous manifestations. A 17-year-old woman presented with a 4-month history of fever and generalised lymphadenopathy. A diagnosis of HNL was established based on a lymph node biopsy. One month later, she developed an erythematoedematous rash on her upper body, with histopathological findings of interface dermatitis. After 8 months, anti-nuclear antibodies (ANA) at titre of 1/320, anti-DNA-ds antibodies and marked decrease of complement levels were detected. During the following 2 years, she developed diagnostic criteria for SLE, with arthralgias, pleuritis, aseptic meningitis, haemolytic anaemia and lupus nephritis. To our knowledge, 27 cases of nodal and cutaneous KD have been reported, 9 of which later developed LE. In all these patients, the skin biopsy revealed interface dermatitis. Skin biopsy revealed a pattern of interface dermatitis in all reviewed KD cases, which evolved into LE. Even this histopathological finding was not previously considered significant; it might be a marker of evolution into LE.

Key Words: Cutaneous lupus erythematosus • histiocytic necrotizing lymphadenitis • interface dermatitis • Kikuchi–Fujimoto’s disease

Lupus, Vol. 17, No. 12, 1127-1135 (2008)
DOI: 10.1177/0961203308092161


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?