Delayed reaction after an octopus bite showing a giant cell-rich granulomatous dermatitis/panniculitis.
Adequate clinical data and a sufficient workup, in addition to the histopathological findings, are frequently required to make a correct diagnosis of granulomatous dermatitis/panniculitis. These lesions with an unexpected etiology may include delayed hypersensitivity granulomatous reactions to various factors, such as metals or marine animal injuries. A 50-year-old male presented with multiple subcutaneous nodules on his right forearm 1 month following an octopus bite at his right wrist. After the disappearance of these lesions, which responded well to low-dose oral prednisone, another type of skin lesion characterized by small, numerous papules reappeared on his right forearm. Histopathologically, a specimen from a subcutaneous nodule showed mostly lobular granulomatous panniculitis, which showed an extensive diffuse infiltrate composed of numerous multinucleated giant cells and epithelioid cells intermingling with lymphocytes and eosinophils. A specimen from a papule that subsequently developed disclosed a diffuse granulomatous dermatitis composed of similar cells and also showed granuloma annulare-like features. This case is considered to be a delayed reaction after an octopus bite showing an unusual giant cell-rich granulomatous dermatitis/panniculitis. Octopus bites should therefore be included among the marine animal injuries, which cause a delayed-type reaction with granulomatous dermatitis/panniculitis.
Faculty of Medicine, Division of Dermatology, Department of Internal Medicine, Saga University, Saga, Japan. misago@post.saga-med.ac.jp
Noriyuki
N
Misago
Takuya
T
Inoue
Yutaka
Y
Narisawa
D000284:Administration, Oral; D000818:Animals; D001733:Bites and Stings / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D003872:Dermatitis / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D005938:Glucocorticoids / Q000627:therapeutic use; D006099:Granuloma / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D049831:Octopodiformes; D015434:Panniculitis / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D011241:Prednisone / Q000627:therapeutic use; D012074:Remission Induction; D016896:Treatment Outcome
D005938:Glucocorticoids; D011241:Prednisone