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Correspondence |

Delayed Diagnosis of Cutaneous Rosai-Dorfman Disease With Distinctive Histologic Features in a Malayan Man

Siew Eng Choon, MBBS(Malaya), FRCP; Zainah Moktar, MD; Ghazali Abdul Ghani, MPath
Arch Dermatol. 2008;144(1):120-121. doi:10.1001/archdermatol.2007.19.
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Sinus histiocytosis with massive lymphadenopathy, or Rosai-Dorfman disease (RDD), is classically seen in a young male patient who presents with bilateral cervical lymphadenopathy and fever.1,2 Extranodal involvement occurs in about 40% of reported cases, usually in association with nodal disease.3 Purely cutaneous RDD, although rare, appears to be more common in the Asian population.4,5 However, without the accompanying lymphadenopathy, cutaneous presentation is nonspecific, and diagnosis is dependent on histologic findings. Herein we describe an Asian patient with characteristic but nonspecific skin lesions whose diagnosis of cutaneous RDD was delayed in the presence of distinctive histologic features.

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Figure 1.

Multiple reddish-brown papules, nodules, and plaques with yellowish centers on the left cheek.

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Pale-staining, large, polygonal histiocytes admixed with plasma cells, neutrophils, some lymphocytes, and occasional Touton giant cells. Emperipolesis of plasma cells with the typical halo is indicated by the arrows (hematoxylin-eosin, original magnification ×40).

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