EBV-ASSOCIATED KIKUCHIS HISTIOCYTIC NECROTIZING LYMPHADENITIS WITH CUTANEOUS MANIFESTATIONS

The clinical and pathologic findings of Kikuchi's histiocytic necrotiz ing lymphadenitis may mimic those of malignant lymphoma. We describe a 6-year-old boy with generalized lymphadenopathy, spiking fever, chill s, myalgias, malaise, and erythematous, crusted papules. Although cuta neous manifestations have been noted in 16% to 40% of patients with hi stiocytic necrotizing lymphadenitis, only three publications described skin lesions. The skin lesions and affected lymph nodes revealed hist iocytic aggregates, atypical lymphoid cells, karyorrhectic debris, and patchy necrosis. Spontaneous resolution occurred in 2 months. Results of serologic studies, Epstein-Barr virus (EBV) latent membrane protei n immunoperoxidase staining, EBER-1 RNA in-situ hybridization, and EBV EBNA-1 DNA polymerase chain reaction implicate EBV as the causative a gent.