Kikuchi-Fujimoto's necrotizing lymphadenitis in association with discoid lupus erthematosus: a case report.
BACKGROUND
Kikuchi-Fujimoto's necrotizing lymphadenitis (KFNL) is a rare, benign, self-limited condition characterized by constitutional symptoms, lymphadenopathy, and skin lesions.


OBJECTIVE
We report a case of KFNL in a 43-year-old East Indian woman with a ten-year history of discoid lupus erythematosus (DLE) of the scalp and a three-month history of a erythematous plaque on the left nasal bridge, cervical lymphadenopathy, and fever. Skin biopsy samples were taken from the face and lymph node.


RESULTS
Histopathological examination of the skin revealed a mixed infiltrate of inflammatory cells, nuclear dust, and histiocytes phagocytosing nuclear debris in the reticular dermis. The lymph node showed interfollicular liquefactive necrosis, immunoblasts, and a similar cellular infiltrate as the skin. The non-necrotic areas demonstrated follicular hyperplasia. These pathological changes are associated with a diagnosis of KFNL.


CONCLUSIONS
KFNL is reported in association with systemic lupus erythematosus, but only two other cases of systemic KFNL in association with DLE exist in the literature. This case is unique in that the patient presented with cutaneous and systemic KFNL in the setting of longstanding DLE.
Division of Dermatology, University of British Columbia, Vancouver, British Columbia, Canada. marasilver@shaw.ca
Shane G
SG
Silver
H Chih-Ho
HC
Hong
Patricia T
PT
Ting
Nigel J
NJ
Ball
D005260:Female; D020042:Histiocytic Necrotizing Lymphadenitis / Q000150:complications / Q000473:pathology*; D006801:Humans; D008179:Lupus Erythematosus, Discoid / Q000150:complications*; D008875:Middle Aged