Syphilitic Juxta-Articular Nodes

Kalz, Frederick

doi:10.1001/archderm.1949.01530030122013

Cited by 9 publications

(2 citation statements)

References 9 publications

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“…Deep morphea, found in one of this patient's fibrotic nodules, is a complication of cutaneous borreliosis . The second fibrotic nodule exhibited the hallmark features of juxta‐articular fibrotic nodules, which are specific for spirochetal infections and differ from rheumatoid nodules based on their singular pattern of lamellar and concentric sclerosis . Immunodetection of organisms with B. burgdorferi ‐specific antibodies within the PCMZL and sclerotic lesions further supports infectious etiology.…”

Section: Discussionmentioning

confidence: 58%

Primary cutaneous marginal zone lymphoma associated with juxta‐articular fibrotic nodules in a teenager

2013

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Primary cutaneous marginal zone lymphoma (PCMZL) has rarely been reported in teenagers and is occasionally associated with Borrelia burgdorferi infection. Juxta-articular fibrotic nodules represent a unique, localized fibrosing response to spirochete infections, namely Borreliosis. Herein, we report a 15-year-old healthy boy who presented with a 4-year history of progressive acquisition of asymptomatic, erythematous nodules, ≤ 3 cm, beginning with his right forearm (3), then right arm (1) and lastly his right inner thigh (1). Biopsy showed PCMZL in three of five samples, and inflamed, fibrotic nodules, near the elbow in two. The bottom heavy lymphomatous nodules consisted of mostly small CD20+ CD43+ lymphocytes, some with plasmacytoid features. Mature plasma cells were lambda light chain restricted by in situ hybridization. The juxta-articular fibrotic nodules were located in the deep dermis and subcutis, had peripheral plasma cell-rich infiltrates, and showed nodular sclerosis (morphea profunda-like) in one, and lamellar and angiocentric sclerosis in the other reminiscent of quiescent lesions of chronic localized fibrosing leukocytoclastic vasculitis. Immunohistochemistry for B. burgdorferi revealed rare positive organisms; however, polymerase chain reaction (PCR) and serology were negative for B. burgdorferi as were serologic and/or PCR assays for Bartonella henselae, Ba. quintana, Ehrlichia chaffeensis, Treponema pallidum, Helicobacter pylori and Babesia microti. No evidence of extracutaneous disease was found by the review of systems and imaging studies. A 4-week trial of doxycycline therapy failed, whereas intralesional (IL) corticosteroid therapy induced rapid regression of his nodules. After two local recurrences, also treated with IL corticosteroids, he is well, without cutaneous disease, 20 months later. A literature review of 19 pediatric cases PCMZL reveals a similar natural history as adult PCMZL. Despite negative serology and PCR for B. burgdorferi, the occurrence of ipsilateral juxta-articular fibrotic nodules, positive B. burgdorferi immunohistochemistry and rapid response to IL corticosteroids implicate the presence of a replicative or non-replicative infectious (spirochetal) antigen in the initiation and promotion of this teenager's PCMZL.

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Section: Discussionmentioning

confidence: 58%

Primary cutaneous marginal zone lymphoma associated with juxta‐articular fibrotic nodules in a teenager

2013

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“…These include cases associated with Trichophyton rubrum, conidiobolomycosis, syphilis, yaws, and Borrelia burgdorferi. [9][10][11][12][13][14] To the best of our knowledge, this is the first case of LCFV associated with tattoo ink.…”

Section: Discussionmentioning

confidence: 99%

Localized Chronic Fibrosing Vasculitis in a Tattoo

Deeken

Jefferson

Hawkinson

et al. 2014

The American Journal of Dermatopathology

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Decorative tattoos are associated with a variety of adverse cutaneous reactions. We describe a unique fibrosing vasculitic reaction to red tattoo ink. The histopathology was similar to that in localized chronic fibrosing vasculitis (LCFV), but sharply limited to sites of red tattoo ink injection and associated with florid verrucoid epidermal hyperplasia. LCFV has been described in a broad variety of slowly progressive disorders with a firm consistency such as erythema elevatum diutinum, plasma cell granuloma, granuloma faciale, and IgG4-associated sclerosing diseases. It has been hypothesized that LCFV is the result of maladaptive immune reaction with failure to clear the causative antigen. To the best of our knowledge, this is the first case of LCFV associated with tattoo. We speculate on the implications our case holds for the pathogenesis of LCFV.

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Syphilis

Beerman¹

1951

AMA Arch Intern Med

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Syphilitic Juxta-Articular Nodes

Cited by 9 publications

References 9 publications

Primary cutaneous marginal zone lymphoma associated with juxta‐articular fibrotic nodules in a teenager

Primary cutaneous marginal zone lymphoma associated with juxta‐articular fibrotic nodules in a teenager

Localized Chronic Fibrosing Vasculitis in a Tattoo

Syphilis

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