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Marion Delplanque, François Chasset, Pierre Hirsch, Florent Malard, Yoan Ditchi, Olivier Fain, Arsene Mekinian, Cutaneous lupus with Kikuchi disease-like inflammatory pattern associated with myelodysplastic syndrome, Rheumatology, Volume 58, Issue 3, March 2019, Pages 554–556, https://doi.org/10.1093/rheumatology/key413
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Sir, Cutaneous lupus erythematosus (CLE) encompasses a wide range of skin manifestations with various clinical and histological patterns. Recently, a new histological pattern of CLE, rather isolated or consisting of other more suggestive features of CLE, has been described. Kikuchi disease-like inflammatory pattern (KLIP) is defined by a dermal infiltrate composed of mononuclear cells, with nuclear debris but without neutrophils [1]. This pattern was defined by diffuse or localized inflammatory infiltrates reminiscent of cutaneous Kikuchi-Fujimoto disease (KFD), without lymph-node related KFD. We report a case of myelodysplastic syndrome and CLE with histologic evidence of KLIP.
A 67-year-old European woman had a diagnosis of low-risk myelodysplastic syndrome in 2009. The myelodysplastic syndrome subtype was multilineage cytopenias and dysplasia with chromosome 20 deletion and low risk on the Revised International Prognostic Scoring System. Since 2010, she presented diffuse, painful, sometimes erosive erythematous and violaceous papulonodular skin lesions that initially affected extremities (Fig. 1A), then extended to hands, thighs, arms, breasts, ears and nose (Fig. 1B).
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