Can Hansen’s disease mimic histiocytosis? Histiocytosis a possibility in nonresponsive and incompletely investigated cases of Hansen’s disease

Abstract

Introduction: Generalized eruptive histiocytosis (GEH) is a rare histiocytosis of the skin that presents in adults as multiple asymptomatic skin colored papules and nodules on the face, trunk and proximal upper limbs in a symmetrical manner. The lesions occur in crops and regress on their own. Clinical and histopathological examination differentiates this condition from other histiocytoses and from the more common disease leprosy, which it mimics closely. We describe a case of GEH mimicking Hansen’s disease (HD).Case presentation: A 26 year old female presented to us with complaints multiple, asymptomatic, skin colored to slightly erythematous nodules and flat papules of size 5-10 mm diameter on the malar area of the face, forehead, lower trunk, and arms. The mucosae, hair, nails, palms and soles were unaffected. Systemic examination including peripheral nerves was unremarkable. Skin biopsy showed full thickness of dermis filled with nodular aggregations of large histiocytes and a small number of lymphocytes. Based on clinical and histopathological findings, a diagnosis of generalized eruptive histiocytosis was made.Conclusion: We conclude that generalized eruptive histiocytosis can simulate histoid Hansen’s disease (HD) and cause diagnostic difficulty. Hence, every case of Hansen’s disease should be properly evaluated for correct diagnosis and management.