Korean J Dermatol.  2006 Apr;44(4):470-473.

A Case of Hemophagocytic Syndrome Manifested as Generalized Skin Eruption in Childhood Atopic Dermatitis

• Park SJ
• Song HJ
• Kim CW
• Lee KS

Abstract

We report a case of 15-year-old patient, previously diagnosed with atopic dermatitis, who presented with generalized erythematous purpuric patches and petechiae on the face, trunk and extremities. The skin lesions appeared 7 days prior to presentation, accompaied by a high grade fever (38.9 degrees C). The lesions had rapidly become aggrevated after an upper respiratory infection, resulting in severe itching sensation. On physical examination, hepatosplenomegly and cervical lymphadenopathy were noted. The laboratory test showed marked pancytopenia, elevated liver enzymes, hypertriglyceridemia, elevated lactic dehydrogenase level and increased ferritin level. Many hemophagocytic macrophages were detected in bone marrow biopsy. A skin biopsy revealed panniculitis composed of histiocytes and lymphocytes. Hemophagocytic syndrome was diagnosed, and treatment with combination chemotherapy resulted in complete remission.

Keyword

Hemophagocytic macrophage; Hemophagocytic syndrome

MeSH Terms

Adolescent
Biopsy
Bone Marrow
Dermatitis, Atopic*
Drug Therapy, Combination
Extremities
Ferritins
Fever
Histiocytes
Humans
Hypertriglyceridemia
Liver
Lymphatic Diseases
Lymphocytes
Lymphohistiocytosis, Hemophagocytic*
Macrophages
Oxidoreductases
Pancytopenia
Panniculitis
Physical Examination
Pruritus
Purpura
Sensation
Skin*
Ferritins
Oxidoreductases