Cytophagic histiocytic panniculitis improved by combined CHOP and cyclosporin A treatment

In a 31-year-old Japanese man with cytophagic histiocytic panniculitis (CHP ) remission was achieved by a combination of combined chemotherapy CHOP and cyclosporin A treatment, He was admitted to our hospital in January 1994 w ith recurrent high fever of 40.2 degrees C and tender and violaceous subcut aneous nodules on his trunk, arms and legs. He developed pancytopenia, hemo rrhagic diathesis, liver dysfunction, Histological examination of the biops ied subcutaneous nodule revealed a lobular panniculitis with fat necrosis a nd a massive infiltration of histiocytes phagocytosing nuclear debris. He w as treated initially with 40 mg/day prednisolone, However, following a redu ction in prednisolone dosage, his symptoms reappeared, CHOP (cyclophosphami de, doxorubicin, vincristine and prednisolone) therapy was then initiated. Three courses of CHOP treatment alleviated his symptoms and cyclosporin A w as used to maintain his condition for 15 months, His medication was then di scontinued and he has been in complete remission for 10 months, Combined tr eatment of cyclosporin A and CHOP combined chemotherapy was shown to be eff ective for this patient with severe CHP.