An unusual presentation of histiocytosis X

A 20-year-old, single Saudi man was examined in the outpatient clinic in January 1980, complaining of ulcers in the groin, discharge from the right ear, and gum enlargement of 2 years' duration. Also in 1980, ulcerating lesions developed in both axillae. One year later the patient was admitted to the hospital for spontaneous pneumothorax, and in the same year a small nodule in the upper left eyelid and fissuring of the nails were noted. In 1982, the patient complained of perianal ulceration and rapidly enlarging submandibular swelling with multiple sinuses and ranula.