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Open Access Highly Accessed Case report

Eosinophilic panniculitis presenting with Kaposi’s sarcoma-like plaques in a patient who is human immunodeficiency virus positive: a case report

Pelin Ustuner1*, Nursel Dilek2, Yunus Saral2, Aziz Ramazan Dilek3 and Recep Bedir4

Author Affiliations

1 Rize State Hospital, Dermatology Clinic, Eminettin Caddesi, Hastaneler Kavşağı, Rize, 53100, Turkey

2 Department of Dermatology, Recep Tayyip Erdoğan University School of Medicine, İslampaşa mahallesi, Tıp Fakültesi Dekanlığı, Rize, 53100, Turkey

3 Department of Microbiology, Recep Tayyip Erdoğan University School of Medicine, İslampaşa mahallesi, Tıp Fakültesi Dekanlığı, Rize, 53100, Turkey

4 Department of Pathology, Recep Tayyip Erdoğan University School of Medicine, İslampaşa mahallesi, Tıp Fakültesi Dekanlığı, Rize, 53100, Turkey

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Journal of Medical Case Reports 2012, 6:387  doi:10.1186/1752-1947-6-387

Published: 13 November 2012

Abstract

Introduction

Eosinophilic panniculitis is an unusual type of panniculitis characterized by a prominent infiltration of subcutaneous fat with eosinophils without an exact etiopathogenesis. To the best of our knowledge, up to now eosinophilic panniculitis has been described in only one previous case with human immunodeficiency virus disease in the literature.

Case presentation

Here we report the case of a 44-year-old Caucasian man, who is human immunodeficiency virus positive, diagnosed with eosinophilic panniculitis. A dermatological examination revealed multiple, confluent Kaposi’s sarcoma-like purple colored, deep plaques and nodules on his right gluteal area and right thigh. The presence of the mixed inflammatory infiltrate of lymphocytes, macrophages, and numerous eosinophils involving both septa and lobules of the subcutis were noted on the histopathological examination. On the basis of all these clinical and histopathological findings the patient was diagnosed with eosinophilic panniculitis. He was given intravenous 60mg/day methylprednisolone for 3 consecutive days a week for 6 months. The lesions resolved almost completely after 6 months.

Conclusion

The predominance of T helper-2 subset of T helper cells and the consequential increase in interleukin-5 cytokines accompanying peripheral eosinophilia and high serum immunoglobulin E levels may all be blamed for the development of eosinophilic panniculitis in our case study. As a result, we aim to emphasize that eosinophilic panniculitis should be kept in mind in the differential diagnosis of subcutaneous nodular lesions in patients who are human immunodeficiency virus positive. We also focus on the requirement of histopathological examination for the definitive diagnosis because the clinical features of eosinophilic panniculitis may easily be confused with Kaposi’s sarcoma.

Keywords:
Eosinophilic panniculitis; Human immunodeficiency virus; Kaposi’s sarcoma; Panniculitis