Subject(s)
Granuloma/pathology , Necrobiotic Disorders/pathology , Nijmegen Breakage Syndrome/pathology , Child , Female , Granuloma/drug therapy , Granuloma/immunology , Granuloma/microbiology , Humans , Necrobiotic Disorders/drug therapy , Necrobiotic Disorders/immunology , Necrobiotic Disorders/microbiology , Nijmegen Breakage Syndrome/diagnosis , Nijmegen Breakage Syndrome/genetics , Nijmegen Breakage Syndrome/immunology , Skin/immunology , Skin/microbiology , Skin/pathologyABSTRACT
BACKGROUND: Necrobiotic xanthogranuloma (NXG) is a rare histiocytic disorder of unknown origin. OBJECTIVE: We conducted an investigation of skin biopsy specimens from 7 patients with NXG for the presence of Borrelia by focus-floating microscopy. METHODS: Focus-floating microscopy is a recently described, modified immunohistochemical technique in which the sections of a slide are simultaneously scanned both horizontally and vertically. Focus-floating microscopy is more sensitive for the detection of micro-organisms than polymerase chain reaction. RESULTS: Borrelia could be detected as single, paired, or clusters of spirochetes in 6 cases of NXG whereas two cases investigated with a Borrelia-specific polymerase chain reaction (23s-RNA) remained negative. LIMITATIONS: Limited biopsy material in each patient prohibited a more detailed study of the life history of cutaneous lesions in NXG. CONCLUSIONS: The detection of this micro-organism in NXG points to a specific involvement of B burgdorferi or other similar strains in the development of or as a trigger of this disease.
