case_images: PMC5850706_01
case_images: Hemophagocytic lymphohistiocytosis (a, H and E, x400). Bone marrow biopsy showing hypocellular marrow showing presence of histiocytes with engulfed lymphocytes (blue arrow head on left side) and red blood cells (black arrow head on right side). Skin biopsyshowing parakeratosis, acanthosis, and necrotic keratinocytes (b, H, and E, x400)
case_images: AJTS-12-85-g002.jpg
case_images: PMC5850706_01_AJTS-12-85-g002.jpg
case_images: F1
case_images: Postmortem bone marrow biopsy [Figure 1a] showed extensive hemophagocytosis; skin biopsy [Figure 1b] showed acanthosis; and presence of necrotic keratinocytes in the epidermis suggestive of toxic epidermal necrolysis (TEN) and liver biopsy revealed micro and macro steatosis.