Cutaneous malakoplakia arising on the ankle of a patient with pyoderma gangrenosum

Carli P Whittington; Jasmine S Saleh; Eric Schadler; Carole Bitar; Frank Wang; Aleodor A Andea

doi:10.1111/cup.14519

Cutaneous malakoplakia arising on the ankle of a patient with pyoderma gangrenosum

J Cutan Pathol. 2023 Nov;50(11):942-946. doi: 10.1111/cup.14519. Epub 2023 Aug 24.

Authors

Carli P Whittington^{1

2

3}, Jasmine S Saleh^{1

2}, Eric Schadler², Carole Bitar⁴, Frank Wang², Aleodor A Andea^{1

2}

Affiliations

¹ Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA.
² Department of Dermatology, University of Michigan, Ann Arbor, Michigan, USA.
³ Departments of Pathology and Dermatology, Indiana University, Indianapolis, Indiana, USA.
⁴ Departments of Pathology and Dermatology, Tulane University, New Orleans, Louisiana, USA.

PMID: 37615213
DOI: 10.1111/cup.14519

Abstract

Malakoplakia is a rare chronic inflammatory condition that most commonly involves the urogenital tract. Cutaneous malakoplakia is extremely rare and many patients diagnosed with skin involvement are immunosuppressed. While the clinical presentation of cutaneous malakoplakia is variable, the histopathologic features are quite distinct and include sheets of closely packed dermal histiocytes with foamy-appearing cytoplasm and Michaelis-Gutmann bodies that are positive with certain immunohistochemical stains. While the exact pathogenesis of malakoplakia is unknown, it has been associated with certain bacterial infections. Treatment generally involves a combination of surgery and antimicrobial agents and/or modulation of immunosuppressant therapy if appropriate. Herein, the authors report a unique case of cutaneous malakoplakia arising in a patient on chronic immunosuppressive therapy for the management of pyoderma gangrenosum.

Keywords: granulomatous; immunosuppression; malakoplakia; pyoderma gangrenosum.

Publication types

Case Reports