Allergy Asthma Respir Dis.  2020 Jan;8(1):45-49. 10.4168/aard.2020.8.1.45.

A case of IgG4-related disease associated with psoriasis-like skin rash and hypereosinophilic syndrome

• Park HK
• Han MH
• Lee SJ

• KMID: 2469119
• DOI: http://doi.org/10.4168/aard.2020.8.1.45

Abstract

Immunoglobulin (Ig) G4-related disease (IgG4-RD) is newly recognized immune-mediated and fibroinflammatory conditions with various organ involvements. Any organs can be involved, but the pancreas, salivary gland, lymph nodes, and orbit are known to be commonly involved organs. A 54-year-old man presented with complaint of psoriasis like skin rash developed 4 years prior to admission. Although he had been treated for skin rash, the extent of skin lesions increased as well as hypereosinophilia, and multiple lymphadenopathies were newly developed. The patient was diagnosed with IgG4-RD by serum IgG4 levels and histologic examination of the inguinal lymph node. One month after treatment with steroid and azathioprine, his skin rash and lymphadenopathies resolved with improvement and eosinophil count was within the normal range. We herein report a case of a IgG4-RD patient associated with psoriasis-like skin rash and hypereosinophilic syndrome.

Keyword

IgG4-related disease; Psoriasis; Hypereosinophilic syndrome

MeSH Terms

Azathioprine
Eosinophils
Exanthema*
Humans
Hypereosinophilic Syndrome*
Immunoglobulin G
Immunoglobulins
Lymph Nodes
Middle Aged
Orbit
Pancreas
Psoriasis
Reference Values
Salivary Glands
Skin*
Azathioprine
Immunoglobulin G
Immunoglobulins

Figure

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  Fig. 1 Skin lesion of IgG4-related disease patient.

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  Fig. 2 Pathology of skin lesion. H&E staining (A, ×100; B, ×200), parakeratosis (yellow arrow), Munro's abscess (red arrow).

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  Fig. 3 Pathology of inguinal lymph node. (A) CD138 (plasma cell) staining (A, ×40; B, ×200), (C) IgG staining (×400), and (D) IgG4 staining (×400).

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  Fig. 4 Skin lesion of IgG4-related disease patient after treatment.

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