Multicentric Reticulohistiocytosis: Elective Excision of Symptomatic Hand Nodules With 1-Year Follow-Up

Multicentric reticulohistiocytosis is a rare non-Langerhans cell histiocytic rheumatologic disorder characterized by multiple skin lesions, painful hand nodules, and destructive polyarthritis that results in arthritis mutilans in 20% to 30% of patients. In the current literature, there have been approximately 300 cases reported and the pathogenesis remains unclear. Currently, there is no diagnostic serologic test and no consensus on management. In this case report, we present a patient with multicentric reticulohistiocytosis who was treated with selective excision of 3 painful nodules on the hand. The patient was seen 1 year after surgery. One of the nodules reoccurred whereas the other 2 remained quiescent. This procedure has the potential to produce considerable pain relief and improve quality of life in a disease process for which optimal medical regimen remains to be determined.