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Chen X, An L, Jiang Z, Jia Y. A case report of multicentric reticulohistiocytosis with atypical cutaneous presentation. Front Immunol 2024; 15:1344313. [PMID: 38426104 PMCID: PMC10903083 DOI: 10.3389/fimmu.2024.1344313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024] Open
Abstract
Multicentric reticulohistiocytosis (MRH) is a rare systemic disorder characterized by histiocytic hyperplasia that mainly involves the skin, mucous membranes, and joints. The typical clinical features include papules, nodules, and arthritis. MRH lesions are relatively extensive but small and scattered. Joint inflammation is characterized by diffuse symmetric polyarthritis as the first symptom, which can be severe and disabling due to destructive joint changes. MRH is easily misdiagnosed in clinical practice. Here, we report the case of an elderly male patient who presented with polyarticular pain in the hip and interphalangeal joints as the first manifestation, followed by the development of large, isolated, bulging skin nodules, which are atypical MRH lesions. This is rare in all MRH case reports, and we made the correct diagnosis by combining skin histopathology, immunohistochemistry, and other clinical examinations. We performed surgical treatment on the local skin lesions of this patient. This case suggests that clinicians should actively correlate the condition and accurately diagnose MRH when encountering atypical skin changes or other diseases as the first symptom and explore the mechanisms of MRH and other clinical manifestations.
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Affiliation(s)
| | | | | | - Yuxi Jia
- Department of Dermatology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
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Mariotti EB, Corrà A, Lemmi E, Laschi L, Aimo C, Quintarelli L, Volpi W, Nacci F, Verdelli A, Ruffo di Calabria V, Guiducci S, Caproni M. Multicentric Reticulohistiocytosis Associated with an Early Form of Systemic Lupus Erythematosus: A Case Report of a Rare Disease, with Mini Review of the Literature. J Clin Med 2022; 11:6529. [PMID: 36362761 PMCID: PMC9658768 DOI: 10.3390/jcm11216529] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/16/2022] [Accepted: 11/01/2022] [Indexed: 08/10/2023] Open
Abstract
Multicentric reticulohistiocytosis (MRH) is the most frequently described form of reticulohistiocytosis (RH), and it is classified as a class IIb non-Langerhans cell histiocytosis. It has been designated as multicentric, being characterized by multisystemic involvement. In fact, although mainly involving the skin, along with the joints, it is a systemic inflammatory condition potentially involving every internal organ. As MRH-related skin findings can mimic rheumatoid nodules or Gottron papules, the histopathology of the cutaneous lesions is often necessary for the correct diagnosis. Approximately one-third of MRH patients have confirmed concomitant autoimmune disorders. A wide variety of autoimmune disorders associated with the disease have been reported in the literature, suggesting immune dysfunction as a factor in the pathophysiology of MRH. A case of MRH associated with autoimmune manifestation is reported in the context of a mini review of the literature, with a focus on clinical presentation, treatments, and treatment outcomes. Moreover, eight cases of MRH associated with autoimmune diseases are briefly discussed.
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Affiliation(s)
| | - Alberto Corrà
- Section of Dermatology, Department of Health Sciences, University of Florence, 50125 Florence, Italy
| | - Elisa Lemmi
- Section of Anatomical Pathology, Department of Health Sciences, University of Florence, 50125 Florence, Italy
| | - Lucrezia Laschi
- Section of Anatomical Pathology, Department of Health Sciences, University of Florence, 50125 Florence, Italy
| | - Cristina Aimo
- Section of Dermatology, Department of Health Sciences, University of Florence, 50125 Florence, Italy
| | - Lavinia Quintarelli
- Rare Disease Skin Unit, Section of Dermatology, Azienda USL Toscana Centro, University of Florence, 50125 Florence, Italy
| | - Walter Volpi
- Section of Dermatology, Azienda USL Toscana Centro, 50125 Florence, Italy
| | - Francesca Nacci
- Section of Rheumatology, Department of Clinical and Experimental Medicine, University of Florence, 50125 Florence, Italy
| | - Alice Verdelli
- Section of Dermatology, Azienda USL Toscana Centro, 50125 Florence, Italy
| | | | - Serena Guiducci
- Section of Rheumatology, Department of Clinical and Experimental Medicine, University of Florence, 50125 Florence, Italy
| | - Marzia Caproni
- Rare Disease Skin Unit, Section of Dermatology, Azienda USL Toscana Centro, University of Florence, 50125 Florence, Italy
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Generalized Progressive Papulonodular Skin Lesions in a 37-Year-Old Man: Answer. Am J Dermatopathol 2021; 42:1008-1009. [PMID: 33289982 DOI: 10.1097/dad.0000000000001609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bonometti A, Berti E. Reticulohistiocytoses: a revision of the full spectrum. J Eur Acad Dermatol Venereol 2020; 34:1684-1694. [PMID: 31955466 DOI: 10.1111/jdv.16214] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 12/31/2019] [Indexed: 12/11/2022]
Abstract
Reticulohistiocytoses (RH) are rare and clinically heterogeneous histiocytic disorders of dermatological interest. Three clinical entities with superimposable histopathological features are currently considered, namely solitary reticulohistiocytoma, diffuse/generalized reticulohistiocytosis and multicentric reticulohistiocytosis. Although in the last decade, RH studies have only minimally progressed, histiocytosis research has advanced considerably: the prognostic and therapeutic importance of the clinical subclassification of histiocytosis patients as well as of the detection of genetic alterations in the genes of the ERK pathway has been highlighted. According to these insights, we previously reported the presence of molecular alteration RH and described a subset of patients with disseminated multisystem involvement lacking arthritis. In the present review, we aim to update and revise the knowledge regarding RH. We first reviewed their histopathological, immunophenotypical and ultrastructural features, discussed their histopathological differential diagnosis with other conditions characterized by infiltrates made of oncocytic or epithelioid cells (with special regard to Destombes-Rosai-Dorfman disease) and finally summarized the molecular landscape of RH. We therefore tried to adjust the clinical subclassification of Langerhans cell histiocytosis to the clinical phenotypes of RH, outlining five clinically different groups of patients. Finally, we reconsidered the clinical workflow to the evaluation of RH patients, in light of the 5 different clinical groups and discussed the different therapeutic approaches and the possible role of target inhibitors.
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Affiliation(s)
- A Bonometti
- Unit of Anatomic Pathology, Department of Molecular Medicine, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy
| | - E Berti
- Unit of Dermatology, IRCCS Ca' Granda - Maggiore Policlinico Hospital Foundation, University of Milan, Milan, Italy
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Wetzel M, Owen CE, Callen JP. Paraneoplastic Syndromes for the Inpatient Dermatologist. CURRENT DERMATOLOGY REPORTS 2019. [DOI: 10.1007/s13671-019-00277-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Islam AD, Naguwa SM, Cheema GS, Hunter JC, Gershwin ME. Multicentric Reticulohistiocytosis: a Rare Yet Challenging Disease. Clin Rev Allergy Immunol 2013; 45:281-9. [DOI: 10.1007/s12016-013-8362-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Fett N, Liu RH. Multicentric Reticulohistiocytosis with Dermatomyositis-Like Features: A More Common Disease Presentation than Previously Thought. Dermatology 2011; 222:102-8. [DOI: 10.1159/000323254] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Accepted: 11/23/2010] [Indexed: 11/19/2022] Open
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