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

Authors

  • Tasleem Arif Ellahi Medicare clinic, Srinagar, Kashmir, India.
  • Mohammad Adil Department of Dermatology. Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University (AMU), Aligarh, India

Keywords:

Generalized eruptive histiocytosis, histiocytosis, Hansen’s disease, histoid leprosy, skin colored papules.

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.

Author Biographies

Tasleem Arif, Ellahi Medicare clinic, Srinagar, Kashmir, India.

Dr. Tasleem Arif.MBBS, MD (Dermatology, STD & Leprosy).Ellahi Medicare clinic, Srinagar, Kashmir, India.Cell number: +919557480345.Permanent Address: New colony Soura, near water supply control room, Srinagar, Kashmir, India.PIN: 190011Email: dr_tasleem_arif@yahoo.com

Mohammad Adil, Department of Dermatology. Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University (AMU), Aligarh, India

Mohammad Adil MBBS, MD (Dermatology, STD’s & Leprosy).Assistant professor, Department of Dermatology.Jawaharlal Nehru Medical College (JNMC), Aligarh Muslim University (AMU), Aligarh, India.Email: dr.mohd.adil@gmail.com

References

Tran TH, Pope E,Weitzman S. Cutaneous histiocytosis. In: Griffiths CEM, Barker J, Bleiker T, Chalmers R,Creamer D, editors. Rook's Textbook of Dermatology. 9th ed. Oxford: Wiley Blackwell; 2016. p. 136.1-29.

Montero I, Gutiérrez-González R, Ginarte M, Toribio J. Generalized eruptive histiocytosis in a patient with chronic myelomonocytic leukemia. ActasDermosifiliog 2012;103:643-4.

Emile JF, Alba O, Fraitag S, Home A, Haroche J, Donadieu J, et al. Revised classification of histiocytoses and neoplasms of the macrophage-dendritic cell lineages. Blood 2016;127:2672-81.

Marzano AV, Facchetti M, Caputo R. Guess what! Generalized eruptive histiocytosis (histiocytoma). Eur J Dermatol 2002;12:205-6.

Klemke CD, Dippel E, Geilen CC, Koenigsmann MP, Thiel E, Orfanos CE, et al. Atypical generalized eruptive histiocytosis associated with acute monocytic leukemia. J Am AcadDermatol 2003;49:S233-6.

Kaffenberger B, Darabi K, Peters S, Kynyk J, Bechtel M. Generalized eruptive histiocytomas and RosaiDorfman disease presenting concurrently in a patient with myelodysplastic syndrome. J Clin Aesthetic Dermatol 2012;5:42-6.

Mahajan RS, Shah AC, Pasle RK, Bilimoria FE. Asymptomatic papular eruption in a 60 year old man.Indian J Dermatol 2015;60:516-7.

Lan Ma H, Metze D, Luger TA, Steinhoff M. Successful treatment of generalized eruptive histiocytoma with PUVA. J DtschDermatolGes 2007;5:131-4.

Tang X, Shen H, Xu A, Sun X, Wang Y, Shi G, et al. Spontaneous regression of generalized eruptive histiocytosis: Possible involvement of apoptosis? Int J Dermatol 2007;46:1073-5.

Deng YJ, Hao F, Zhou CL, Sun RS, Xiang MM, Wang JW. Generalized eruptive histiocytosis: a possible therapeutic cure? Br J Dermatol 2004;150:171-3.

Goodman WT, Barrett TL. Histiocytoses. In: Bolognia JL, Jorizzo JL, Schaffer JV, editors. Dermatology. 3rd ed. Philadelphia: Elsevier Saunders; 2012. p. 1529-46.

Caputo R, Marzano AV, Passoni E, Berti E. Unusual variants of nonlangerhanscell histiocytoses. J Am AcadDermatol 2007;57:1031-45.

Ruíz GA, Ruíz BA, Fraile AH, Martinez PI, Muñoz GM. Progressive nodular histiocytosis accompanied bysystemic disorders. Br J Dermatol 2000;143:628-31.

Rao AG, Lakshmi TS, Vani V. Multicentricreticulohistiocytosis. Indian J DermatolVenereolLeprol 2003;69:35-6.

Verma SB. Generalized eruptive histiocytomasand juvenile eruptive xanthogranulomas in a 10-year-old boy: a potpourri of exotic terms indicatingthe need for unification. Int J Dermatol. 2012;51:445-7.

Sharath Kumar BC, Nandini AS, Niveditha SR, Gopal MG, Reeti. Generalized eruptive histiocytosis mimicking leprosy.IndianJ DermatolVenereolLeprol2011;77:498-502

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Published

2021-03-04

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Case Reports