Cutaneous granulomas in children with combined immunodeficiency

Cutaneous granulomas are small red spots on the skin that can be swollen, inflamed, or infected. They can appear in association with a variety of different infectious diseases, and they can occur in people who have poor immune function due to immunodeficiency disorders or treatment with immunosuppressive drugs. (The immune system is the body's natural defense system for fighting infection. Patients who have undergone transplant surgery require treatment with drugs that suppress the immune system to prevent rejection of the donated tissue.) Cutaneous granulomas located on the arms, legs and face may be an early warning sign of immunodeficiency. This article describes the case reports of three children who developed cutaneous granulomas on their legs, arms and faces. All three children had severe lung and ear infections during early childhood. Not until after the cutaneous granulomas appeared was it determined that these children had some form of immunodeficiency. None of the children had AIDS or infection with HIV (the virus that causes AIDS). One child required a bone marrow transplant because of chronic anemia (abnormally low numbers of red blood cells). One year after the transplant the child developed cutaneous granulomas. Treatment with prednisone improved the skin lesions in this child. Prednisone improved the skin lesions in the other two children as well, but both of them died from severe immunodeficiency. It is concluded that children who develop cutaneous granulomas should be examined and tested for immunodeficiency. (Consumer Summary produced by Reliance Medical Information, Inc.)