Nodular Panniculitis with Hemophagocytic Lymphohistiocytosis

To the Editor:A 27-year-old Chinese man presented to the hospital complaining of red nodules on the chest and back that gradually enlarged with spiking fever up to 39℃.He had nodular panniculitis when he was 21 years old.The family history was silent.Physical examination on admission revealed skin pigmentation,skin nodules (four,2cm × 2cm,without movement and tenderness), and red rash without pain and pruritus over the body.Laboratory tests showed pancytopenia,especially for white blood cell (WBC) and platelet (PLT),raised triglycerides (TGs)and ferritin levels, liver enzyme abnormalities,decreased albumin value,and deranged coagulation profile.