title: Histologically distinctive papular neutrophilic xanthomas in HIV-1 + patients.
abstract: Xanthomas may be associated with benign or malignant lymphoproliferative diseases, often with associated hypergammaglobulinema. In human immunodeficiency virus type 1 (HIV-1) disease, there is a high lymphoproliferative rate despite the immunodeficiency and increased cell death. We report three HIV-1-positive patients with facial papular xanthomatosis eruptions associated with hypergammaglobulinema, and an immunoglobulin A (IgA) gammopathy. Histopathologic features include lipid-laden macrophages, extracellular nuclear dust with phagocytosized nuclear debris, and hyalinization with areas of hyaline necrosis of collagen fibers. These distinctive papular xanthomas may be a marker of HIV-1 disease and of a pattern of immunodysregulation, immunodeficiency, and lymphoid proliferation seen in HIV-1 disease.
authors.affiliation: National Naval Medical Center, Bethesda, Maryland 20814, USA.
authors.forename: K J
authors.initials: KJ
authors.lastname: Smith
authors.forename: J
authors.initials: J
authors.lastname: Yeager
authors.forename: H G
authors.initials: HG
authors.lastname: Skelton
mesh_terms: D000328:Adult; D005145:Face; D005260:Female; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D006801:Humans; D006818:Hyalin / Q000378:metabolism; D006942:Hypergammaglobulinemia / Q000150:complications; D007070:Immunoglobulin A; D008297:Male; D009336:Necrosis; D014973:Xanthomatosis / Q000150:complications* / Q000378:metabolism / Q000473:pathology*
chemical_list: D007070:Immunoglobulin A