Extraordinary Case ReportLupus Erythematosus Tumidus Associated With HemophagocytosisGeorgiadou, Nikki MBBS, BDS Hons, MFDS RCSEd*; Singh, Sarita MBBS, MD, BSC Hons, FRCP*; Singh, Manuraj MBBS Hons, MRCP, PhD, DipRCPath† Author Information *Department of Dermatology, Chelsea and Westminster Hospital, London, United Kingdom; and †Department of Dermatopathology, St George's University Hospital, London, United Kingdom. Correspondence: Nikki Georgiadou, MBBS, BDS Hons, MFDS RCSEd, Imperial College of Science Technology and Medicine, Imperial College London, London, Greater London, United Kingdom (e-mail: [email protected]). The authors declare no conflicts of interest and have gained informed consent from the patient detailed in our report. The American Journal of Dermatopathology: July 2022 - Volume 44 - Issue 7 - p 519-522 doi: 10.1097/DAD.0000000000002188 Buy Metrics Abstract A case of lupus erythematosus tumidus (LET), a subtype of chronic cutaneous lupus erythematosus, in an 85-year-old woman who presented with discrete indurated erythematous plaques over the face and upper chest is described. A skin biopsy showed features in keeping with a diagnosis of LET. Unusually however, the lymphocytic infiltrate contained frequent macrophages that demonstrated hemophagocytosis. Most of the phagocytosed cells were lymphocytes, but there was also evidence of erythrophagocytosis. The presence of conspicuous hemophagocytosis has only rarely been reported in skin biopsies of patients with autoimmune conditions. These include systemic lupus, neonatal lupus and dermatomyositis, and on 2 occasions in cases of nonspecified cutaneous lupus erythematosus. To the best of our knowledge, hemophagocytosis as a feature of LET has not been previously described in the literature. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.