Kikuchi-Fujimoto Disease Presenting as Refractory Eyelid Lesions Mimicking Chalazia.
May A Ameri, George A Villatoro, Patricia Chevez-Barrios et al.
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Case in brief
A 16-year-old male with prior biopsy-proven Kikuchi-Fujimoto disease developed recurrent lesions of both left eyelids over 2 years, initially considered chalazia. The lesions persisted despite repeated incision and drainage and progressed to eyelid thickening and mechanical ptosis. MRI showed cervical, parotid, and supraclavicular lymphadenopathy, with enhancement of the lacrimal glands and eyelids. Eyelid biopsy revealed necrotizing lymphohistiocytic inflammation supporting extranodal Kikuchi-Fujimoto disease and excluding lymphoma, chalazia, and infection. After incisional biopsy and intralesional corticosteroid injection, he improved markedly, with no recurrence at postoperative month 1.
What made this case unusual
Extranodal Kikuchi-Fujimoto disease presented as chronic eyelid lesions mimicking chalazia, a rare periocular manifestation that persisted despite repeated drainage procedures.
Diagnostic / clinical pearl
Recurrent eyelid lesions that do not respond as expected to chalazion procedures warrant reconsideration of the diagnosis; biopsy can identify extranodal Kikuchi-Fujimoto disease and help exclude lymphoma or infection.