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Specific Cutaneous Involvement in Whipple Disease

Canal, Laia MD*; Fuente, Diana de la MD; Rodriguez-Moreno, Jesús MD; Penin, Rosa M. MD; Marcoval, Joaquim MD*

The American Journal of Dermatopathology: April 2014 - Volume 36 - Issue 4 - p 344–346
doi: 10.1097/DAD.0000000000000008
Brief Report

Abstract: Cutaneous lesions in Whipple disease (WD) are infrequent, and the histological findings are usually nonspecific. Specific cutaneous lesions have rarely been described and usually involve the subcutaneous fat. We report a patient diagnosed with WD, who developed multiple small subcutaneous nodules after antibiotic treatment was administered. In addition to septal panniculitis, the cutaneous biopsy showed a mild granulomatous dermal reaction with PAS-positive macrophages characteristic of WD. A positive polymerase chain reaction in the cutaneous sample confirmed the presence of Tropheryma whipplei in the skin. Dermatopathologists should be aware that not only subcutaneous lesions but also dermal lesions may exhibit specific findings of WD.

Departments of *Dermatology,

Rheumatology, and

Pathology, Hospital Universitari de Bellvitge, Barcelona, Spain.

Reprints: Joaquim Marcoval, MD, Department of Dermatology, Hospital Universitari de Bellvitge, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona 08907, Spain (e-mail:

The authors declare no conflicts of interest.

© 2014 by Lippincott Williams & Wilkins.