Extremely rare diffuse dermatological manifestations in an Iranian patient suffering from Kimura’s disease

Kimura’s disease (KD) is a rare chronic inflammatory condition of unknown origin. This case report described a unique presentation of KD in a 35-year-old Iranian woman who presented to the Emergency Department in March 2021 with hematuria, proteinuria, diffuse painless, and non-tender white cutaneous lesions affecting the head, neck, chest, and hands, with no swelling. Laboratory assessments showed micro-proteinuria, without oliguria, as well as peripheral serum eosinophilia (10%). Other laboratory findings were unremarkable. Histopathological analysis of skin lesion biopsies showed epidermal focal erosion, hyperkeratosis, parakeratosis, acanthosis, and intact basal layer, as well as dermal interstitial and perivascular infiltration of lymphocytes, histiocytes, and a few eosinophils, with plump endothelial cells in vessels. The diagnosis of KD was confirmed. Hematuria and proteinuria resolved without specific treatment within two days. The skin lesions remained persistent. This case deviated from the typical presentation of KD, as it involved a non-oriental female patient with diffuse cutaneous involvement. Increased awareness of atypical presentations is crucial for preventing misdiagnosis in the evaluation of suspected KD cases.