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October 1978

Lymphomatoid Granulomatosis Preceded by Chronic Granulomatous Dermatitis

Author Affiliations

From the Departments of Pathology (Drs Bender and Kapadia) and Dermatology (Drs Synkowski and Zitelli), University of Pittsburgh School of Medicine.

Arch Dermatol. 1978;114(10):1547-1548. doi:10.1001/archderm.1978.01640220090027

Lymphomatoid granulomatosis is a lymphoreticular proliferative disorder that involves the lungs, skin, and CNS.1,2 A case of skin eruption that underwent spontaneous resolution as pulmonary involvement appeared is reported.

Report of a Case  A 55-year-old man had a skin eruption for nine weeks that involved the face, trunk, and arms. The lesions were elevated, erythematous, and annular, with central clearing and hypesthesia. A skin biopsy specimen showed chronic granulomatous inflammation (Fig 1). He was receiving no medication on discharge.Fig 1.—Focal dermal periappendigeal and perivascular chronic inflammatory infiltrate (hematoxylin-eosin, ×5.45).Fig 2.—Consolidated lung, with centrally necrotic nodules.Fig 3.—Mixed infiltrate of chronic inflammatory cells with binucleate histiocytes (left, arrow) and mitoses (right) (hematoxylin-eosin, ×530).In two weeks he was readmitted with progressive dyspnea, tachycardia, and tachypnea. Arterial Pco2 was 32 mm Hg; Po3 was 47 mm Hg. Chest x-ray film showed bilateral patchy interstitial and nodular infiltrates. The