Erythrophagocytosis in the skin: case report

A 68-year-old male with a myelodysplastic syndrome developed a bulla on his right thigh. A skin biopsy revealed a subepidermal cleavage containing fibrin and a mononuclear cell infiltrate exhibiting prominent erythrophagocytosis. Erythrophagocytosis by mononuclear cells was present, to a lesser extent, throughout the dermis and in the subcutis. Immunoperoxidase studies with anti-lysozyme and anti-alpha-l-chymotrypsin confirmed the histiocytic nature of the phagocytic cells. Only a few prior reports of cutaneous erythrophagocytosis exist in the literature. In contrast to the generally grave clinical manifestations of the patients described in previous publications documenting erythrophagocytosis, this patient lacked a concomitant hematologic deterioration or serious systemic illness.