Cytophagic Histiocytic Panniculitis and Kikuchi-Fujimoto-Like Lymphadenitis in a Patient With Systemic Lupus Erythematosus

Abstract

A 54-year-old African American male with systemic lupus erythematosus and chronic alcoholic hepatitis presented with recurrent fever, pancytopenia, transaminitis, weight loss, and widespread violaceous tender plaques. Skin biopsy revealed hemophagocytic histiocytes leading to a diagnosis of cytophagic histiocytic panniculitis in the setting of lupus panniculitis. During workup, an axillary lymph node biopsy mimicked Kikuchi-Fujimoto's disease. Treatment with tapering high-dose glucocorticoids, mycophenolate mofetil, and hydroxychloroquine induced remission of the disease. We believe the comorbid conditions of Kikuchi-Fujimoto-like pathology and cytophagic histiocytic panniculitis have not been documented in the literature to date in a patient with systemic lupus erythematosus.

Clinicopathological Characteristics and Outcome of Cytophagic Histiocytic Panniculitis: A Single-Center, Retrospective Study

“…1,6 Most cases reported in the English literature presented with a benign form and responded to less aggressive treatment, mainly immunosuppressive treatment rather than cytotoxic therapy in the past 10 years. 3,[7][8][9][10] Our findings were consistent with those of previous studies. Hence, we consider that CHP tends to be a reactive disorder complicated by protopathic diseases, although the primary disease cannot be determined in some patients due to the limitations of pathologic processes, the opportune moment of biopsy, and detection technology.…”