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Yoshiki Tokura, MD; Yasuko Tamura, MD; Masahiro Takigawa, MD; Masayo Koide, MD; Takahiro Satoh, MD; Taiko Sakamoto, MD; Daisuke Horiguchi, MD; Mizuho Yamada, MD

Arch Dermatol. 1990;126(3):362-368.

Abstract
• A 2-year-old girl showed exaggerated skin reactions to mosquito bites and associated general symptoms, including a high temperature, lymphadenopathy, and hepatosplenomegaly. Peripheral blood lymphocytes contained a high percentage of CD2⁺, CD3^-, CD4^-, CD8^-, CD11b⁺, CD16⁺, CD38⁺, CD56⁺, CD57^-, and HLA-DR⁺ large granular lymphocytes that exhibited a marked natural killer cell activity. Immunohistochemically, biopsy specimens taken from the lesional skin demonstrated an infiltrate of the cells bearing the natural killer cell phenotype, indicating a role of these cells in the development of the abnormal skin reactions to mosquito bites and other systemic manifestations. Our case suggests that natural killer cell lymphocytosis may show severe hypersensitivity to mosquito bites as the most outstanding manifestation.

(Arch Dermatol. 1990;126:362-368)

Author Affiliations
From the Department of Dermatology, Hamamatsu (Japan) University School of Medicine (Drs Tokura, Takigawa, Sakamoto, Horiguchi, and Yamada); the Departments of Pediatrics (Dr Tamura) and Dermatology (Dr Koide), Hamamatsu (Japan) Red Cross Hospital; and the Department of Dermatology, School of Medicine, Tokyo (Japan) Medical and Dental University (Dr Satoh).

Footnotes
Accepted for publication August 27, 1989.

Reprint requests to Department of Dermatology, Hamamatsu University School of Medicine, 3600 Handa-cho, Hamamatsu 431-31 Japan (Dr Tokura).

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