Indian Journal of Dermatology
  Publication of IADVL, WB
  Official organ of AADV
Indexed with Science Citation Index (E) , Web of Science and PubMed
 
Users online: 642  
Home About  Editorial Board  Current Issue Archives Online Early Coming Soon Guidelines Subscriptions  e-Alerts    Login  
    Small font sizeDefault font sizeIncrease font size Print this page Email this page


 
Table of Contents 
QUIZ
Year : 2017  |  Volume : 62  |  Issue : 3  |  Page : 325-327
Widespread indurated plaques and nodules


1 Department of Dermatology, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
2 Department of General Medicine, South West Healthcare Warrnambool Base Hospital, Victoria, Australia

Date of Web Publication12-May-2017

Correspondence Address:
Evelyn Yap
Department of Dermatology, Hospital Sultanah Aminah, Johor Bahru, Johor
Malaysia
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijd.IJD_597_16

Rights and Permissions



How to cite this article:
Yap E, Lee S, Tey KE, Choon SE. Widespread indurated plaques and nodules. Indian J Dermatol 2017;62:325-7

How to cite this URL:
Yap E, Lee S, Tey KE, Choon SE. Widespread indurated plaques and nodules. Indian J Dermatol [serial online] 2017 [cited 2019 Sep 18];62:325-7. Available from: http://www.e-ijd.org/text.asp?2017/62/3/325/206189


A 55-year-old Malay woman presented with widespread, asymptomatic skin lesions of 4 years duration. She reported recurrent nasal blockage since 2005 requiring surgical excisions for nasal masses. There was associated lethargy without other constitutional symptoms. Physical examination revealed pallor, multiple indurated violaceous plaques and nodules over the bilateral upper and lower limbs, trunk, and back [Figure 1]a,[Figure 1]b,[Figure 1]c. There was no lymphadenopathy or hepatosplenomegaly.
Figure 1: (a-c) Multiple indurated violaceous plaques and nodules involving bilateral upper and lower limbs, trunk, and back

Click here to view


Laboratory indices confirmed anemia with reticulocytosis (5.69%) and a positive indirect Coombs test. Computed tomography scan revealed right paratracheal lymphadenopathy measuring 4.9 cm × 4.5 cm × 6.5 cm. A punch biopsy was taken from one of the skin lesions.

Histopathological examination revealed dense, diffuse dermal infiltrates of foamy histiocytes, some multinucleated, admixed with abundant lymphocytes, plasma cells, and some neutrophils [Figure 2]. Russell bodies were occasionally sighted in the plasma cells. Emperipolesis was also noted [Figure 3]. Foamy cells were positive for CD68 and S-100 while negative for CD1a [Figure 4].
Figure 2: Dense diffuse dermal infiltrates of foamy histiocytes, some multinucleated, admixed with abundant lymphocytes, plasma cells, and some neutrophils (H and E, ×10)

Click here to view
Figure 3: A lymphocyte existed within a macrophage, consistent with the finding of emperipolesis (H and E, ×40)

Click here to view
Figure 4: Foamy cells were positive for S-100 immunostain (S-100 stain, ×40)

Click here to view



   Question Top


What is your diagnosis?



Click here to view answer. View Answer


 
   References Top

1.
Rosai J, Dorfman RF. Sinus histiocytosis with massive lymphadenopathy. A newly recognized benign clinicopathological entity. Archives of pathology. 1969 Jan 1;87(1):63-70.  Back to cited text no. 1
    
2.
Maia RC, de Meis E, Romano S, Dobbin JA, Klumb CE. Rosai-Dorfman disease: A report of eight cases in a tertiary care center and a review of the literature. Braz J Med Biol Res 2015;48:6-12.  Back to cited text no. 2
[PUBMED]    
3.
Lai KL, Abdullah V, Ng KS, Fung NS, van Hasselt CA. Rosai-Dorfman disease: Presentation, diagnosis, and treatment. Head Neck 2013;35:E85-8.  Back to cited text no. 3
[PUBMED]    
4.
Wang KH, Chen WY, Liu HN, Huang CC, Lee WR, Hu CH. Cutaneous Rosai-Dorfman disease: Clinicopathological profiles, spectrum and evolution of 21 lesions in six patients. Br J Dermatol 2006;154:277-86.  Back to cited text no. 4
[PUBMED]    
5.
Sachdeva M, Abdulhaq H. A rare case of Rosai-Dorfman disease in an adult male associated with auto-immune hemolytic anemia. Mediterr J Hematol Infect Dis 2013;5:e2013022.  Back to cited text no. 5
[PUBMED]    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

Top
Print this article  Email this article
 
 
  Search
 
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Article in PDF (1,406 KB)
    Citation Manager
    Access Statistics
    Reader Comments
    Email Alert *
    Add to My List *
* Registration required (free)  


   Question
   Answer
   Discussion
    References
    Article Figures

 Article Access Statistics
    Viewed1089    
    Printed14    
    Emailed0    
    PDF Downloaded74    
    Comments [Add]    

Recommend this journal