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Kikuchi–Fujimoto's Necrotizing Lymphadenitis in Association with Discoid Lupus Erthematosus: A Case Report

  • Case Report
  • Published:
Journal of Cutaneous Medicine and Surgery

Abstract

Background

Kikuchi–Fujimoto's necrotizing lymphadenitis (KFNL) is a rare, benign, self-limited condition characterized by constitutional symptoms, lymphadenopathy, and skin lesions.

Objective

We report a case of KFNL in a 43-year-old East Indian woman with a ten-year history of discoid lupus erythematosus (DLE) of the scalp and a three-month history of a erythematous plaque on the left nasal bridge, cervical lymphadenopathy, and fever. Skin biopsy samples were taken from the face and lymph node.

Results

Histopathological examination of the skin revealed a mixed infiltrate of inflammatory cells, nuclear dust, and histiocytes phagocytosing nuclear debris in the reticular dermis. The lymph node showed interfollicular liquefactive necrosis, immunoblasts, and a similar cellular infiltrate as the skin. The non-necrotic areas demonstrated follicular hyperplasia. These pathological changes are associated with a diagnosis of KFNL.

Conclusions

KFNL is reported in association with systemic lupus erythematosus, but only two other cases of systemic KFNL in association with DLE exist in the literature. This case is unique in that the patient presented with cutaneous and systemic KFNL in the setting of longstanding DLE.

Sommaire

Antécédents

La maladie de Kikuchi–Fujimoto, ou lymphadénite histiocytaire nécrosante, est une maladie rare, bénigne et résolutive, qui se caractérise par des symptômes constitutionnels, une adénopathie et des lésions cutanées.

Objectifs

Nous rapportons un cas de lymphadénite histiocytaire nécrosante chez une femme de 43 ans, originaire des Indes orientales, ayant un lupus érythémateux discoïde du cuir chevelu depuis dix ans et présentant, depuis trois mois, une plaque érythémateuse sur la voûte nasale gauche, une adénopathie cervicale et de la fièvre. Des échantillons de biopsie ont été prélevés du visage et des ganglions lymphatiques.

Résultats

L'examen histopathologique de la peau a révélé un infiltrat mixte de cellules inflammatoires, de poussière nucléaire et de phagocytes de débris nucléaires dans le derme réticulaire. Le ganglion lymphatique a montré une nécrose liquéfiante interfolliculaire, des immunoblastes et un infiltrat cellulaire similaire à la peau. Les zones non nécrosées ont présenté une hyperplasie folliculaire. Ces changements pathologiques sont associés à un diagnostic de la maladie de Kikuchi-Fujimoto.

Conclusion

La maladie de Kikuchi–Fujimoto est rapportée en présence d'un lupus érythémateux discoïde. Deux autres cas seulement ont été décrits dans les publications spécialisées. Le présent cas est unique du fait que la lymphadénite histiocytaire nécrosante s'est déclarée en présence d'un lupus érythémateux discoïde de longue date.

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Authors and Affiliations

  1. Division of Dermatology, University of British Columbia, Vancouver, British Columbia, Canada

    Shane G. Silver & H. Chih-ho Hong

  2. Division of Dermatology, University of Manitoba, Winnipeg, Manitoba, Canada

    Shane G. Silver

  3. University of Calgary Medical School, Calgary, Albert, Canada

    Patricia T. Ting

  4. Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada

    Nigel J. Ball

Authors
  1. Shane G. Silver
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  2. H. Chih-ho Hong
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  3. Patricia T. Ting
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  4. Nigel J. Ball
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Corresponding author

Correspondence to Shane G. Silver.

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Silver, S.G., Hong, H.Ch., Ting, P.T. et al. Kikuchi–Fujimoto's Necrotizing Lymphadenitis in Association with Discoid Lupus Erthematosus: A Case Report. J Cutan Med Surg 8, 442–445 (2004). https://doi.org/10.1007/s10227-004-0119-3

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  • DOI: https://doi.org/10.1007/s10227-004-0119-3

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