Kikuchi's disease (histiocytic necrotizing lymphadenitis) associated with cutaneous lupus erythematosus

Histiocytic necrotizing lymphadenopathy (Kikuchi's disease) is a rarely observed clinical entity characterized by fever and solitary or multiple lymphadenopathy predominantly in the posterior cervical region. Kikuchi's disease has been reported to precede, coexist with or follow the diagnosis of systemic lupus erythematosus. In only rare instances has its association with cutaneous lupus erythematosus without systemic involvement been reported. We report two cases who presented with characteristic manifestations of Kikuchi's disease. One to two months later, they developed lesions of cutaneous lupus erythematosus. The American Rheumatism Association criteria for systemic lupus erythematosus were not fulfilled. The possible pathogenic relationships between the two processes are discussed.