Cutaneous malakoplakia in an HIV-positive patient

Savant, S R; Amladi, Sangeeta; Kangle, S D; Wadhwa, S. L.; Nayak, ChitraS

doi:10.1258/095646207781024801

Cited by 18 publications

(9 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Drugs such as oral steroids, azathioprine, and cyclophosphamide have been given to transplant recipients and patients with autoimmune disorders 2,3 . There are also reports of malakoplakia in HIV patients, some of whom have demonstrated a CD4 count of <25, which supports the suggestion that immune suppression may be a promoting factor in the pathogenesis of malakoplakia 2,4 . More than half of patients appear to be immunosuppressed 5 .…”

supporting

confidence: 54%

Cutaneous malakoplakia: a rare diagnosis of chronic nodules over the buttocks

Verma¹

2011

Int J Dermatology

View full text Add to dashboard Cite

An 87-year-old retired farmer presented to our clinic with a history of plaques and nodules over his lower back. He appeared to be very healthy for his age. On examination, he was found to have many scaly plaques on the skin over the sacral region, extending over the gluteal cleft, the side of his buttocks, and the inferior part of the gluteal region just above the posterior thighs (Figs 1 and 2). The scales were profuse and were adherent to the erythematous plaques. The plaque on the left gluteal region showed a cluster of four polypoid, firm, and non-tender erythematous nodules (Figs 1 and 2) of four years' duration. The patient stated that the plaques had developed about eight years previously and that he had treated them with topical steroids with varying relief. The nodules had developed only on the left side about four years previously and had minimal discharge intermittently. The patient had no enlargement of lymph nodes anywhere. He had no history of trauma, fever, cough, or weight loss. He was very fit for his age. He had no urinary or abdominal complaints. Abdominal ultrasound was normal. KOH (potassium hydroxide) test, Gram stain, Ziehl-Neelsen stain, bacterial and mycobacterial cultures from pus revealed nothing of significance. The tissue was also subjected to fungal culture but did not yield any fungal growth. Excisional biopsy of a polypoid nodule arising from a plaque revealed diffuse granulomatous infiltrate with some suppurated areas. There were plenty of lymphocytes, epithelioid cells, plasma cells, and occasional Langhans giant cells. The overlying epidermis showed moderate spongiotic psoriasiform changes.The dermis showed fibroplasia with exuberant granulation tissue, and the deeper dermis revealed the presence of multiple basophilic intracytoplasmic inclusions characteristic of Michaelis-Gutmann bodies, thereby clinching the diagnosis of cutaneous malakoplakia. This was confirmed by positive periodic acid-Schiff (PAS) and von Kossa stains (Figs 3 and 4). Because Michaelis-Guttman bodies are seen only sparsely in routine hematoxylin and eosin (H&E) stains, it was considered that a special stain such as von Kossa would render these bodies more visible and appreciable. The plaque adjacent to that with nodules was also biopsied and, interestingly, showed classic changes of psoriasis. As the patient's relatives refused surgery, he was administered 500 mg of oral ciprofloxacin and topical fusidic acid ointment and was advised to have regular follow-up.

show abstract

supporting

confidence: 54%

Cutaneous malakoplakia: a rare diagnosis of chronic nodules over the buttocks

Verma¹

2011

Int J Dermatology

View full text Add to dashboard Cite

show abstract

“…3). 1,2 Immunohistochemistry shows histiocytes positive for CD68 antibodies, whereas Gram stain may demonstrate gram-negative bacteria, most commonly E. coli. 1 Furthermore, within the cells of malakoplakia, intracellular organisms are sometimes seen in phagolysosomes, representing products of incomplete bacterial digestion, which can become calcified and produce M-G bodies.…”

Section: Discussionmentioning

confidence: 99%

Vaginal Malakoplakia

Patel

Maller

Abraham³

et al. 2021

Infectious Diseases in Clinical Practice

View full text Add to dashboard Cite

Malakoplakia is a rare chronic inflammatory disease that predominantly develops in the urogenital system. Although its clinical presentation can vary from asymptomatic to urgent depending on location, mass effect, and other factors, its gross appearance can be mistaken for malignancy. However, the histological identification of von Hansemann histiocytes and Michaelis-Gutmann bodies confirm the diagnosis of malakoplakia. We present a case of a female patient who sought medical care for acute pelvic discomfort attributed to urinary retention after urinary obstruction. Although the discovery of multiple masses within the vagina and pelvic cavity indicated a tumor, it was originally negative for malignancy. Histology of biopsy samples demonstrated Michaelis-Gutmann bodies mixed with lymphoid cells through immunohistochemical and periodic acid-Schiff stains, consistent with a diagnosis of malakoplakia. Despite negative cultures, multiple courses of antibiotics were given, but the mass progressed and caused urinary obstruction. After pelvic exenteration, lymphoma was diagnosed and treated. We review the current literature on malakoplakia in different body sites associated with infections and noninfectious diseases.

show abstract

“…Malakoplakia was first described by Michaelis and Gutmann in 1902 and later by von Hansemann in 1903, who named the lesion after the Greek words ‘ malako ’ meaning soft and ' plakia ' meaning plaque . It is an inflammatory granulomatous condition that usually affects the genitourinary tract in 60–70% percent of the cases , but it has also been described in other anatomic locations, including the gastrointestinal and respiratory tract , prostate, thyroid gland, lymph nodes, bones and joints, middle ear, oropharynx, eyes and brain .…”

Section: Discussionmentioning

confidence: 99%

“…Recent data report that it may occur even in healthy patients. Risk factors for the development of malakoplakia include organ transplantation (23%) , especially in kidney transplant recipients; connective tissue disorders (15%); neoplasm (10%) ; diabetes mellitus (10%); and chronic immunodeficiency disorders, such as HIV, sarcoidosis, hepatitis C, rheumatoid arthritis and haematological malignancies . Prolonged therapy with systemic corticosteroids and the use of azathioprine and cyclophosphamide also contribute in this manner .…”

Section: Discussionmentioning

confidence: 99%

Cutaneous malakoplakia masquerading as pyoderma gangrenosum

Smith-Pliego

Contreras‐Ruiz

Ryan

et al. 2016

International Wound Journal

View full text Add to dashboard Cite

Cutaneous malakoplakia is a rare infection-related granulomatous disease frequently associated with immunocompromised states. Foamy macrophages containing basophilic granules, called the Michaelis-Gutman bodies, are pathognomonic. We report a case of cutaneous malakoplakia in a 77-year-old male with pyoderma gangrenosum and a 2-year history of a non-healing malleolar ulcer treated successfully with cotrimoxazole.

show abstract

Cutaneous malakoplakia in an HIV-positive patient

Cited by 18 publications

References 6 publications

Cutaneous malakoplakia: a rare diagnosis of chronic nodules over the buttocks

Cutaneous malakoplakia: a rare diagnosis of chronic nodules over the buttocks

Vaginal Malakoplakia

Cutaneous malakoplakia masquerading as pyoderma gangrenosum

Contact Info

Product

Resources

About