Related Experiment Videos
Subcutaneous nodules in Whipple's disease
1Servicio de Anatoía Patológica, Hospital Mútua de Terrassa, Terrassa, Barcelona, Spain. 2415xts@comb.es
Journal of Cutaneous Pathology
|July 5, 2001
Summary
Whipple's disease, a rare condition, can manifest as painful subcutaneous nodules. This case highlights the importance of considering Whipple's disease in patients with unexplained panniculitis and foamy macrophages.
Area of Science:
- Gastroenterology
- Dermatology
- Infectious Diseases
Background:
- Whipple's disease is a rare systemic infection typically diagnosed via duodenal biopsy.
- Cutaneous manifestations beyond hyperpigmentation are infrequently reported in Whipple's disease.
Observation:
- A 59-year-old male with known Whipple's disease developed painful, red-brown subcutaneous nodules on his extremities and buttocks.
- Histopathological examination of the nodules revealed septal panniculitis and foamy macrophages.
Findings:
- Foamy macrophages contained periodic acid-Schiff (PAS)-positive, diastase-resistant intracytoplasmic material, consistent with Whipple's disease.
- Ultrastructural analysis confirmed the material represented degenerated bacilli within histiocytes.
- This represents the fourth documented instance of Whipple's disease presenting with subcutaneous involvement.
Implications:
- The findings suggest that Whipple's disease should be considered in the differential diagnosis of patients presenting with septal panniculitis and abundant foamy histiocytes.
- This case expands the known spectrum of cutaneous presentations for Whipple's disease, emphasizing the need for thorough diagnostic evaluation.