Discoid Lupus and Human Immunodeficiency Virus: A Retrospective Chart Review to Determine the Prevalence and Progression of Co-occurrence of these Conditions at a Single Academic Center.

CONTEXT: Discoid lupus erythematosus (DLE) and human immunodeficiency virus (HIV) are both disorders of the immune system. The pathophysiology of these diseases varies greatly as DLE is characterized by an overactive immune system that attacks normal host cells, whereas HIV is characterized by an exogenous attack on the immune system that depletes it of key cell types. Although the reason is unknown, co-occurrence of DLE and HIV is rare. AIMS: The goal of this study is to determine the prevalence of co-occurrence of DLE and HIV and to determine whether patients with both DLE and HIV share any clinical feature. SUBJECTS AND METHODS: The medical records of all patients seen within a single academic health center over a 20-year period were reviewed to determine the prevalence of cutaneous lupus, HIV, and co-occurrence of these conditions. The charts of patients diagnosed with both conditions were further reviewed to determine similarities between them. RESULTS: Of the 10,719 patients diagnosed with HIV and 182 patients diagnosed with cutaneous lupus, only 2 patients were diagnosed with both conditions. Both of these patients were diagnosed with DLE several years after being diagnosed with HIV. They had an undetectable HIV viral load, normal CD4 T-cell counts, and were on antiretroviral therapy when diagnosed with DLE. CONCLUSION: These results confirm that co-occurrence of DLE and HIV is rare. Although our study population was small, findings from these patients suggest that in HIV-positive patients, DLE manifestations occur when their HIV disease activity is minimal.

Histiocytoid giant cellulitis-like Sweet's syndrome: case report and review of the literature.

BACKGROUND: Histiocytoid Sweet syndrome is an uncommon variant in which the dermal infiltrate is composed of mononuclear cells with a histiocytic appearance that represent immature myeloid cells. Giant cellulitis-like Sweet syndrome is a recently described variant characterized by relapsing widespread giant lesions. PURPOSE: We report a unique patient with histiocytoid giant cellulitis-like Sweet syndrome and review the current literature on histiocytoid Sweet syndrome and giant cellulitis-like Sweet syndrome. MATERIAL AND METHODS: We reviewed PubMed for the following terms and have reviewed the literature: histiocytoid, giant cellulitis-like, and Sweet syndrome. RESULTS: Six individuals, including our patient, have been reported with giant cellulitis-like Sweet syndrome; four had obesity, two had a hematologic malignancy, and one had breast cancer. Histiocytoid Sweet syndrome has been reported in association with autoimmune diseases, infection or inflammation, inflammatory bowel disease, malignancies, medications, and other conditions. CONCLUSIONS: Histiocytoid Sweet syndrome is a rare variant of Sweet syndrome, often associated with malignancy. Giant cellulitis-like Sweet syndrome has been reported in six individuals; four of the patients were obese and three of the patients had an associated cancer. Our patient had histiocytoid giant cellulitis-like Sweet syndrome-associated myelodysplastic syndrome/myeloproliferative disorder. The diagnosis of histiocytoid Sweet syndrome or giant cellulitis-like Sweet syndrome should prompt the clinician to consider additional evaluation for a Sweet syndrome-associated malignancy.

Eccrine chromhidrosis secondary to hyperbilirubinemia.

BACKGROUND: Eccrine chromhidrosis, or colored eccrine sweating, may be caused by contamination of sweat by dyes, pigmentation from microorganisms, or more rarely, hyperbilirubinemia. Pigment usually affects the palms and soles, where abundant sweat glands are found.Purpose, Material and Methods: We report a unique case of eccrine chromhidrosis in the setting of hyperbilirubinemia and review the current literature available on PubMed of previously reported cases. RESULTS: Six patients with chromhidrosis have been previously reported in the setting of significant hyperbilirubinemia, in association with fever and thickened stratum corneum. CONCLUSIONS: Eccrine chromhidrosis secondary to hyperbilirubinemia is very rare, but can be diagnosed on the basis of classic clinical findings, dermoscopic examination, and negative tissue cultures.