Erythematosus plaques with macrophage infiltration as an initial manifestation of macrophage activation syndrome in a patient with systemic lupus erythematosus

Mari TochiharaInstitute of Rheumatology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

Mikiko KasaiDepartment of Dermatology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

Yasuhiro KatsumataInstitute of Rheumatology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, JapanCorrespondence[email protected]

Eri SatoInstitute of Rheumatology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

Naoko IshiguroDepartment of Dermatology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

Hiroshi KazamaDepartment of Hematology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

Naoki SugimotoInstitute of Rheumatology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

Hisae IchidaInstitute of Rheumatology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

Yasushi KawaguchiInstitute of Rheumatology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

Hisashi YamanakaInstitute of Rheumatology, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan

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Abstract

The diagnosis of macrophage activation syndrome (MAS) in patients with systemic lupus erythematosus (SLE) may be challenging as it can mimic the clinical features of the underlying disease or be confused with an infectious complication. In this report, a Japanese woman in her forties had diverse clinical features of MAS at initial presentation of SLE, where erythematosus plaques with histiocytic infiltrates focally surrounding degenerated collagen might be the earliest indicator of MAS.

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Erythematosus plaques with macrophage infiltration as an initial manifestation of macrophage activation syndrome in a patient with systemic lupus erythematosus

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Erythematosus plaques with macrophage infiltration as an initial manifestation of macrophage activation syndrome in a patient with systemic lupus erythematosus

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