Cutaneous Manifestations in a Patient With Reactive Hemophagocytic Lymphohistiocytosis

Hemophagocytic lymphohistiocytosis (HLH) is a rare hematologic disease caused by a disordered immune system. We present a case of reactive HLH (RHLH) with uncommon skin findings in a 35-year-old African American female with a history of hidradenitis suppurativa and morbid obesity. Skin findings on physical exam revealed bullous, ecchymotic, hypopigmented, and ulcerated lesions. The literature on the cutaneous lesions of RHLH is limited. Skin findings are an underrecognized feature of RHLH and can help alert to its presence or its recurrence after treatment.