LAUSR

cally by the presence of erythrocytes, platelets, and leukocytes within the cytoplasm of macrophages. There was a report summarizing the biopsies of skin rashes in HPS/HLH. The most common cutaneous manifestations were panniculitis and purpura, and more than half of the cases revealed cytophagocytosis. On the other hand, dermal perivascular hemophagocytosis unrelated to HPS/HLH was first reported in 2007 in two cases of patients with chronic kidney disease; one of them was later found to have marginal zone lymphoma. Recently, 21 cases of cutaneous hemophagocytosis were collected. The majority (11 cases) were associated with a clinical diagnosis of leukocytoclastic vasculitis (petechiae) on the lower extremities, and the others were related to various neutrophil-rich dermatoses. None of the cases had any clinical sign of HPS/HLH. The features of cutaneous hemophagocytosis were found mostly in the papillary and mid dermis, and the subcutaneous fat was not involved. This report suggested that cutaneous hemophagocytosis within the dermis only could represent a form of local macrophagic reaction to remove the nuclear debris. In conclusion, the histopathological finding of cutaneous hemophagocytosis alone is insufficient to label as HPS/HLH, because immune activation with excessive cytokine release caused by malignant neoplasms or other immune abnormalities leads to the findings of hemophagocytosis. As far as we know, this is the first case of UV accompanied by cutaneous hemophagocytosis. We provide an additional clinicopathological variation of cutaneous hemophagocytosis.