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Detection of spirochetal micro-organisms by focus-floating microscopy in necrobiotic xanthogranuloma
Bernhard Zelger1, Klaus Eisendle, Christian Mensing
1Department of Dermatology and Venerology, Innsbruck Medical University, Innsbruck, Austria. bernhard.zelger@i-med.ac.at
Background:
Necrobiotic xanthogranuloma (NXG) is a rare histiocytic disorder of unknown origin.
Objective:
We conducted an investigation of skin biopsy specimens from 7 patients with NXG for the presence of Borrelia by focus-floating microscopy.
Methods:
Focus-floating microscopy is a recently described, modified immunohistochemical technique in which the sections of a slide are simultaneously scanned both horizontally and vertically. Focus-floating microscopy is more sensitive for the detection of micro-organisms than polymerase chain reaction.
Results:
Borrelia could be detected as single, paired, or clusters of spirochetes in 6 cases of NXG whereas two cases investigated with a Borrelia-specific polymerase chain reaction (23s-RNA) remained negative.
Limitations:
Limited biopsy material in each patient prohibited a more detailed study of the life history of cutaneous lesions in NXG.
Conclusions:
The detection of this micro-organism in NXG points to a specific involvement of B burgdorferi or other similar strains in the development of or as a trigger of this disease.
