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Malignant histiocytosis with panniculitis--a case report
1Institute of Dermatology, Bangkok, Thailand.
The Journal of Dermatology
|July 1, 1990
Summary
Malignant histiocytosis, a rare disorder, can present with skin lesions resembling panniculitis. This case highlights the importance of considering this diagnosis in patients with unexplained skin inflammation and systemic symptoms.
Area of Science:
- Hematology
- Dermatology
- Pathology
Background:
- Malignant histiocytosis is a rare neoplastic proliferation of histiocytes.
- Cutaneous manifestations can be the initial presentation, mimicking other inflammatory conditions.
Observation:
- A 32-year-old woman presented with a 7-month history of recurrent skin lesions (plaques, nodules, ulcers), fever, fatigue, arthralgia, and weight loss.
- Skin biopsy revealed lobular panniculitis with mixed cell infiltration; bone marrow aspiration showed increased immature histiocytes with hemophagocytosis.
- The patient exhibited anemia, thrombocytopenia, and impaired liver function with coagulation defects.
Findings:
- Histopathological examination of skin lesions demonstrated features consistent with panniculitis, with a predominance of histiocytes.
- Bone marrow analysis confirmed malignant histiocytosis with hemophagocytic activity.
- Treatment with cyclophosphamide, vincristine, and prednisolone resulted in clinical improvement and resolution of skin lesions.
Implications:
- This case underscores the diverse clinical presentations of malignant histiocytosis, emphasizing the role of dermatological findings.
- Early recognition and diagnosis are crucial for timely initiation of appropriate therapy.
- This report represents the first documented case of malignant histiocytosis presenting as panniculitis in Thailand.