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CASE REPORT
Year : 2022  |  Volume : 26  |  Issue : 2  |  Page : 89-91

CD1a-positive dendritic cell-enriched pigmented purpuric dermatosis in association with dyslipidemia


1 Center for Clinical Studies, Baylor College of Medicine, Houston, TX, USA
2 School of Medicine, Baylor College of Medicine; Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
3 Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
4 Department of Dermatopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Correspondence Address:
Dr. Daniel J Lewis
Department of Dermatology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1452, Faculty Tower/Pickens 411, Houston, TX 77030-4008
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdds.jdds_85_20

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Indeterminate cells (ICs) are dendritic cells (DCs) that share the histologic features of Langerhans cells and macrophages but lack Birbeck granules. It remains unclear whether IC histiocytosis is a separate disease entity or a reactive process. We report the case of a male with an 8-year history of dyslipidemia who developed extensive pigmented purpuric papules. Laboratory studies revealed peripheral monocytosis (8.2%), and two skin biopsies showed a dermal lichenoid lymphohistiocytic infiltrate composed of CD4+ T cells and CD8+ T cells and CD68+CD163+CD1a+Langerin histiocytes. PD-1/PD-L1+T cells were present in the dermis. Our case may help in understanding the pathogenesis of IC histiocytosis, and we hypothesize that expression of CD1a+ dermal DCs and T-cell dysfunction is a reactive process to dyslipidemia.


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