Eyelid edema revealing Kikuchi's disease.

Introduction. In 30 p. too of Kikuchi's disease (or necrotizing histiocytic lymphadenitis), polymorphous and non specific cutaneous manifestations are present. We report herein an original case of Kikuchi's disease in which e yelid edema was the first sign. Case report. An Is-year-old girl was referred to our department for fever, arthralgia, cervical lymphadenitis and an important eyelid edema which had begun 4 days before. The rest of physical examination was normal. Laborator y tests revealed pancytopenia, elevated sedimentation rate, increased trans aminases and normal muscular and thyroid rests. Various serologic studies w ere also negative. Thoracic CT scan, abdominal ultrasound and bone marrow b iopsy showed no sign of lymphoma. Cervical lymph node biopsy revealed necro tizing histiocytic lymphadenitis, without neutrophils, suggesting the diagn osis of Kikuchi's disease. Eyelid edema due to lacrimal gland inflammation was resolved after local injections of cortisone. Our patient recovered wit hout therapy within 3 weeks. No recurrence was observed after 4 months. Discussion. Kikuchi's disease is rare and benign. It is clinically manifest ed by cervical or generalized lymphadenopathy, with fever. Diagnosis is mad e by lymph node biopsy showing necrotizing histiocytic lymphadenitis. The e tiology is not yet well known, although a viral cause is often suspected. T he main differential diagnoses of Kikuchi's disease are lupus erythematosus and lymphoma. Skin lesions are not well described. To our knowledge, we re port herein the first case of eyelid edema revealing Kikuchi's disease. The refore, Kikuchi's disease should now be considered as a new cause of eyelid edema.