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Multicentric Reticulohistiocytosis.

Leah A Goldberg¹, Sylvia Hsu²

¹Department of Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, PA.

|January 3, 2025

Summary

This case study highlights multicentric reticulohistiocytosis (MRH), a rare disorder. Characteristic "coral bead" papules on fingers led to diagnosis, confirmed by skin biopsy showing specific histiocyte cytoplasm.

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Area of Science:

Dermatology
Rheumatology
Pathology

Background:

Multicentric reticulohistiocytosis (MRH) is a rare systemic disorder characterized by histiocytic proliferation.
It often presents with skin lesions and joint pain (arthralgia).
Early diagnosis is crucial for management.

Observation:

A young woman presented with asymptomatic papules on her hands for six months.
Physical examination revealed multiple, dull red, 2-5-mm papules, predominantly in the periungual regions, described as "coral beads".

Findings:

The clinical diagnosis of multicentric reticulohistiocytosis (MRH) was made based on characteristic skin findings.
A skin biopsy confirmed the diagnosis, showing histiocytes with eosinophilic, homogenous, finely granular "ground glass" cytoplasm.

Implications:

This case underscores the importance of recognizing characteristic dermatological signs for diagnosing rare conditions like MRH.
Periungual "coral bead" papules are a key indicator for suspecting MRH.
Skin biopsy remains essential for definitive pathological diagnosis and guiding patient management.