Whittington Carli P, Saleh Jasmine S, Schadler Eric, Bitar Carole, Wang Frank, Andea Aleodor A
Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA.
Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.
J Cutan Pathol. 2023 Nov;50(11):942-946. doi: 10.1111/cup.14519. Epub 2023 Aug 24.
Malakoplakia is a rare chronic inflammatory condition that most commonly involves the urogenital tract. Cutaneous malakoplakia is extremely rare and many patients diagnosed with skin involvement are immunosuppressed. While the clinical presentation of cutaneous malakoplakia is variable, the histopathologic features are quite distinct and include sheets of closely packed dermal histiocytes with foamy-appearing cytoplasm and Michaelis-Gutmann bodies that are positive with certain immunohistochemical stains. While the exact pathogenesis of malakoplakia is unknown, it has been associated with certain bacterial infections. Treatment generally involves a combination of surgery and antimicrobial agents and/or modulation of immunosuppressant therapy if appropriate. Herein, the authors report a unique case of cutaneous malakoplakia arising in a patient on chronic immunosuppressive therapy for the management of pyoderma gangrenosum.
软斑病是一种罕见的慢性炎症性疾病，最常累及泌尿生殖道。皮肤软斑病极为罕见，许多被诊断有皮肤受累的患者存在免疫抑制。虽然皮肤软斑病的临床表现各异，但其组织病理学特征相当独特，包括成片紧密排列的真皮组织细胞，其细胞质呈泡沫状，还有在某些免疫组化染色中呈阳性的米凯利斯-古特曼小体。虽然软斑病的确切发病机制尚不清楚，但它与某些细菌感染有关。治疗通常包括手术与抗菌药物联合使用，以及在适当时调整免疫抑制治疗。在此，作者报告了一例独特的皮肤软斑病病例，该病例发生在一名因坏疽性脓皮病接受慢性免疫抑制治疗的患者身上。
