SKIN INVOLVEMENT IN KIKUCHIS-DISEASE - AN IMMUNOCYTOCHEMICAL AND IMMUNOFLUORESCENCE STUDY

Kikuchi's disease (KD) is a benign self-limiting febrile illness usual ly affecting young women, which is manifested clinically by fever and cervical lymphadenopathy. Skin involvement in Ka is very rare and is e vident clinically in the form of skin rashes and nodules. We describe one such case of KD in a 33-year-old Bulgarian woman who presented wit h cervical and axillary lymphadenopathy and who developed a transient facial rash. Biopsy of axillary lymph nodes showed the characteristic features of KD with infiltration of the lymph node paracortex by apopt otic plasmacytoid monocytes. Biopsies of the facial skin showed two fe atures: (1) dermal infiltration by apoptotic plasmacytoid monocytes; ( 2) on immunofluorescence studies of frozen sections prepared from invo lved and uninvolved facial skin, deposition of immunoglobulins and com plement at the dermoepidermal junction and in the walls of dermal bloo d vessels. Such immunofluorescence findings in the skin of patients wi th KD have never been described. These findings suggest the presence o f an autoimmune reaction as a component of KD.