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Q fever: a new cause of ‘doughnut’ granulomatous lobular panniculitis
Author(s) -
Galache C.,
SantosJuanes J.,
Blanco S.,
Rodríguez E.,
Martínez A.,
Soto J.
Publication year - 2004
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.2004.06125.x
Subject(s) - panniculitis , medicine , exanthem , pathology , q fever , biopsy , dermatology , papule , skin biopsy , bone marrow , immunology , lesion
Summary Q fever is an uncommon zoonotic rickettsial disease with no exanthem or specific cutaneous lesions. Only nonspecific cutaneous involvement has been reported to date. A 69‐year‐old Spanish woman with chronic myelogenous leukaemia developed fever and two subcutaneous nodules. The patient complained of extreme pain. Biopsy revealed a granulomatous lobular panniculitis with a characteristic ‘fibrin ring’ or ‘doughnut’ appearance: fibrin and inflammatory cells arranged around a central clear space. Changes of membranous lipodystrophy were also found. Q fever serological studies were positive. Our patient had panniculitis with singular histopathological features. These histopathological changes have been described in liver and bone marrow of patients with Q fever. To the best of our knowledge, this cutaneous involvement due to Q fever has not previously been described in the literature.