Subcutaneous Dirofilariasis: A Masquerade of a Palisaded Granulomatous Dermatitis

Abstract

Dirofilaria species are roundworms responsible for "heartworm" in canines. On occasion, humans are an accidental host, resulting in pulmonary (D. immitis) or extrapulmonary (D. repens) manifestations. Of the extrapulmonary sites of involvement, subcutaneous involvement is particularly common. We report a case of a 49 year-old female who presented with an erythematous nodule on her shin, which closely resembled necrobiosis lipoidica on histopathologic examination. On closer examination, there were foci of necrosis which harbored segments of the nematode, diagnostic of dirofiliarisis. We present this case to highlight the histopathologic similarities and differences between palisaded necrobiotic conditions and this potentially under-recognized entity.

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