Borrelia Lymphocytoma Mimicking Butterfly Rash in a Pediatric Patient
| Autor: | Mar Llamas-Velasco, Bruno E. Paredes |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Pathology medicine.medical_specialty Anti-nuclear antibody 030106 microbiology Dermatology Pathology and Forensic Medicine Serology Diagnosis Differential 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Pseudolymphoma Borrelia Humans Lupus Erythematosus Systemic Medicine skin and connective tissue diseases Lyme Disease Systemic lupus erythematosus Lupus erythematosus medicine.diagnostic_test biology business.industry General Medicine Exanthema medicine.disease biology.organism_classification Rash medicine.anatomical_structure Child Preschool Skin biopsy Female medicine.symptom business Subcutaneous tissue |
| Zdroj: | The American Journal of Dermatopathology. 40:216-218 |
| ISSN: | 0193-1091 |
| Popis: | A 5-year-old girl presented with a facial butterfly rash that persisted for 5 months without arthralgia, fever, malaise, photosensitivity, or other symptoms. Lupus erythematosus was clinically suspected. All blood tests were negative or within normal values. Skin biopsy showed a dense nodular superficial and deep inflammatory infiltrate of lymphocytes that reaches subcutaneous tissue. The most striking histopathological finding was plasma cells with some perifollicular accentuation. Borrelia polymerase chain reaction assay of the tissue was positive, and we made the diagnoses of borrelia lymphocytoma mimicking butterfly rash of lupus erythematosus. The lesions disappeared with amoxicillin followed by cefuroxime for 28 days. In children, a variety of diseases including lupus erythematous may lead to a butterfly rash that is usually short lasting and commonly associated with systemic symptoms. Borreliosis may be related with long-lasting facial erythema in children and may mimic lupus and present high titers of antinuclear antibodies. In any case, borrelial lymphocytoma has not been previously reported as a cause of butterfly rash, thus mimicking acute lupus in a child, as in our case. From a histopathological point of view, the presence of plasma cells in a pseudolymphomatous infiltrate is a clue for the right diagnosis. Therefore, we suggest that borrelia serology should be done in children with butterfly rash lasting more than a month and empirical antibiotic treatment should be tried even in cases with negative serology. |
| Databáze: | OpenAIRE |
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