1
|
Hetzel JD, Diamond DC, Ramsey ZC, Henson JW, Powell MR. Postherpetic granulomatous dermatitis occurring in the setting of immune checkpoint inhibitor therapy: A case report. J Cutan Pathol 2024; 51:30-33. [PMID: 37589212 DOI: 10.1111/cup.14511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/21/2023] [Accepted: 07/31/2023] [Indexed: 08/18/2023]
Abstract
We report a case of a 72-year-old man presenting with a 2-month history of a persistent, painful rash of the chest, axilla, and back. He had a history of recently resolved varicella zoster virus reactivation in the same distribution of the current rash and metastatic malignant melanoma treated with nivolumab and ipilimumab. The histopathology was consistent with granulomatous dermatitis (GD), and a diagnosis of postherpetic isotopic response manifesting as GD was made. Given the paucity of reported cases of postherpetic GD in the setting of treatment with immune checkpoint inhibitors (ICIs), we discuss the clinicopathologic features of this case and potential mechanisms by which ICIs may contribute to the development of granulomatous disease.
Collapse
Affiliation(s)
- John D Hetzel
- Department of Dermatology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Davis C Diamond
- Department of Dermatology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Zachary C Ramsey
- Department of Pathology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - John W Henson
- Department of Neurology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
- Heme/Onc Division, Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Matthew R Powell
- Department of Dermatology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
- Department of Pathology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| |
Collapse
|
2
|
Zhang D, Wanat KA, Perelygina L, Rosenbach M, Haun PL, Drolet BA, Shields BE. Cutaneous granulomas associated with rubella virus: A clinical review. J Am Acad Dermatol 2024; 90:111-121. [PMID: 37271455 DOI: 10.1016/j.jaad.2023.05.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/22/2023] [Accepted: 05/25/2023] [Indexed: 06/06/2023]
Abstract
Since the initial identification of vaccine-derived rubella virus (RuV) in the cutaneous granulomas of pediatric patients with inborn errors of immunity in 2014, more than 80 cases of RuV granulomas have been reported implicating both vaccine-derived and wild type RuV. Previously thought to arise exclusively in patients with significant immunocompromise, the identification of RuV granulomas in clinically immunocompetent patients adds nuance to our understanding of the interplay between host environment, immune dysregulation, and RuV granuloma formation. This review summarizes the literature on RuV granulomas including clinical and histopathologic features, proposed pathomechanisms supporting granuloma development, and potential therapeutic options. There is no standardized algorithm to guide the workup and diagnosis of suspected RuV granulomas. We highlight the importance of contributing RuV granuloma cases to ongoing Centers for Disease Control and Prevention surveillance efforts to monitor wild type and vaccine-derived RuV transmission. Studies advancing our understanding of RuV granulomas may provide insights into the role of viral infectious agents in granulomatous disease pathogenesis and guide the development of improved therapeutic options.
Collapse
Affiliation(s)
- Donglin Zhang
- Department of Dermatology, University of Wisconsin School of Medicine, Madison, Wisconsin
| | - Karolyn A Wanat
- Department of Dermatology and Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Ludmila Perelygina
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Misha Rosenbach
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Paul L Haun
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Beth A Drolet
- Department of Dermatology, University of Wisconsin School of Medicine, Madison, Wisconsin
| | - Bridget E Shields
- Department of Dermatology, University of Wisconsin School of Medicine, Madison, Wisconsin.
| |
Collapse
|
3
|
Pollard B, McCoy WH, Leonardi CL, Martin AG. Wolf's isotopic response of lichen planus following contact dermatitis. JAAD Case Rep 2022; 27:128-130. [PMID: 36046802 PMCID: PMC9421081 DOI: 10.1016/j.jdcr.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Bruin Pollard
- Medical Education Program, Washington University School of Medicine, St Louis, Missouri
| | - William H McCoy
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Missouri
| | - Craig L Leonardi
- Department of Dermatology, Saint Louis University School of Medicine, St Louis, Missouri
| | - Ann G Martin
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Missouri
| |
Collapse
|
4
|
Tripathy DM, Kumar S, Saraswat N, Goel S, Ranjan E. Post herpetic granulomatous dermatitis and herpes zoster necroticans triggered by Covid-19 vaccination. Dermatol Ther 2022; 35:e15707. [PMID: 35811450 PMCID: PMC9350396 DOI: 10.1111/dth.15707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/18/2022] [Accepted: 07/08/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Sushil Kumar
- Dermatology, Motilal Nehru Medical College, Allahabad, India
| | | | | | | |
Collapse
|
5
|
El Jammal T, Jamilloux Y, Gerfaud-Valentin M, Richard-Colmant G, Weber E, Bert A, Androdias G, Sève P. Challenging Mimickers in the Diagnosis of Sarcoidosis: A Case Study. Diagnostics (Basel) 2021; 11:diagnostics11071240. [PMID: 34359324 PMCID: PMC8304686 DOI: 10.3390/diagnostics11071240] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 12/19/2022] Open
Abstract
Sarcoidosis is a systemic granulomatous disease of unknown cause characterized by a wide variety of presentations. Its diagnosis is based on three major criteria: a clinical presentation compatible with sarcoidosis, the presence of non-necrotizing granulomatous inflammation in one or more tissue samples, and the exclusion of alternative causes of granulomatous disease. Many conditions may mimic a sarcoid-like granulomatous reaction. These conditions include infections, neoplasms, immunodeficiencies, and drug-induced diseases. Moreover, patients with sarcoidosis are at risk of developing opportunistic infections or lymphoma. Reliably confirming the diagnosis of sarcoidosis and better identifying new events are major clinical problems in daily practice. To address such issues, we present seven emblematic cases, seen in our department, over a ten-year period along with a literature review about case reports of conditions misdiagnosed as sarcoidosis.
Collapse
Affiliation(s)
- Thomas El Jammal
- Department of Internal Medicine, Lyon University Hospital, 69004 Lyon, France; (T.E.J.); (Y.J.); (M.G.-V.); (G.R.-C.); (E.W.); (A.B.)
| | - Yvan Jamilloux
- Department of Internal Medicine, Lyon University Hospital, 69004 Lyon, France; (T.E.J.); (Y.J.); (M.G.-V.); (G.R.-C.); (E.W.); (A.B.)
| | - Mathieu Gerfaud-Valentin
- Department of Internal Medicine, Lyon University Hospital, 69004 Lyon, France; (T.E.J.); (Y.J.); (M.G.-V.); (G.R.-C.); (E.W.); (A.B.)
| | - Gaëlle Richard-Colmant
- Department of Internal Medicine, Lyon University Hospital, 69004 Lyon, France; (T.E.J.); (Y.J.); (M.G.-V.); (G.R.-C.); (E.W.); (A.B.)
| | - Emmanuelle Weber
- Department of Internal Medicine, Lyon University Hospital, 69004 Lyon, France; (T.E.J.); (Y.J.); (M.G.-V.); (G.R.-C.); (E.W.); (A.B.)
| | - Arthur Bert
- Department of Internal Medicine, Lyon University Hospital, 69004 Lyon, France; (T.E.J.); (Y.J.); (M.G.-V.); (G.R.-C.); (E.W.); (A.B.)
| | - Géraldine Androdias
- Department of Neurology, Service Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Lyon University Hospital, F-69677 Bron, France;
| | - Pascal Sève
- Department of Internal Medicine, Lyon University Hospital, 69004 Lyon, France; (T.E.J.); (Y.J.); (M.G.-V.); (G.R.-C.); (E.W.); (A.B.)
- Research on Healthcare Performance (RESHAPE), INSERM U1290, 69373 Lyon, France
- Correspondence: ; Tel.: +33-426-732-636
| |
Collapse
|
6
|
Yoon JH, Jang YJ, Park EJ, Kim KJ, Kim KH. A Case of Herpes Zoster Granulomatous Dermatitis: Report of Wolf's Isotopic Response. Ann Dermatol 2021; 33:186-189. [PMID: 33935462 PMCID: PMC8081995 DOI: 10.5021/ad.2021.33.2.186] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/06/2020] [Accepted: 01/09/2020] [Indexed: 11/13/2022] Open
Abstract
Wolf's isotopic response refers to the occurrence of a novel skin disease at the site of a preceding treated or untreated skin disease. Although the most common preceding skin disease was found to be herpes zoster (HZ), HZ-related dermatological phenomena are not well known in the literature. We report a case of HZ granulomatous dermatitis in a 77-year-old female with a previous history of hypertension, diabetes mellitus, chronic kidney disease, and HZ. She presented with a 3-month history of a pruritic skin lesion on her right thigh. The location of the lesion was consistent with a previous HZ site. Histopathological examination revealed lympho- histiocytic infiltration in the superficial dermis, forming a granulomatous structure. Based on clinical and histopathological findings, we made a diagnosis of granulomatous dermatitis at a previous HZ site. We assumed that the lesion arose from an isotopic response of Wolf. The patient was treated with topical steroids for 3 months and showed clearance of the lesion and symptom. We suggest that treatment should be based on the individual disease, which in our case was topical steroid.
Collapse
Affiliation(s)
- Ji Ha Yoon
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Ye Ji Jang
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Eun Joo Park
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Kwang Joong Kim
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Kwang Ho Kim
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| |
Collapse
|
7
|
Atypical Herpes Simplex Presenting Necrotizing Granulomas in an Immunocompromised Patient. Am J Dermatopathol 2020; 42:305-306. [PMID: 31188142 DOI: 10.1097/dad.0000000000001462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
8
|
Mann E, Maruthi R, Friedland MH, Chung HJ, McGee JS. Case of post-herpetic, isotopic granuloma annulare (GA), followed by generalized GA. J Dermatol 2019; 46:e476-e477. [PMID: 31553074 DOI: 10.1111/1346-8138.15088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Emily Mann
- Department of Dermatology, Boston University School of Medicine, Boston, MA, USA
| | - Rohit Maruthi
- Department of Dermatology, Boston University School of Medicine, Boston, MA, USA
| | - Matthew H Friedland
- Department of Dermatology, Boston University School of Medicine, Boston, MA, USA
| | - Hye Jin Chung
- Department of Dermatology, Boston University School of Medicine, Boston, MA, USA
| | - Jean S McGee
- Department of Dermatology, Boston University School of Medicine, Boston, MA, USA
| |
Collapse
|