Reticulohistiocytosis: different dermatoscopic faces and a good response to methotrexate treatment.
The reticulohistiocytoses are a rare group of non-Langerhans cell histiocytic disorders. Recently, dermatoscopic features have been reported for some of the xanthomatous disorders. We report a case of diffuse cutaneous reticulohistiocytosis with 29 reticulohistiocytomas. On dermatoscopy of these lesions, we saw three typical features: a homogeneous pattern with various shades of yellow (defined previously as a 'setting-sun' pattern), brown reticular structures, and central white scar-like patches and streaks. The setting-sun pattern was most commonly seen in combination with brown reticular structures. In four lesions, brown reticular structures surrounded a central white scar-like patch resembling that of a dermatofibroma. However, the presence of the setting-sun pattern in the background gave a different hue to that of the peripheral network seen in a dermatofibroma. A marked clinical improvement was associated with 6 months of systemic methotrexate treatment. Dermatoscopy may aid in the diagnosis of xanthomatous diseases. For this patient, methotrexate was beneficial.
Kaçar
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Department of Dermatology, Pamukkale University, Denizli, Turkey. n_gelincik@yahoo.com
Tasli
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L
Argenziano
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G
Demirkan
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N
D003879:Dermatologic Agents / Q000627:therapeutic use*; D046169:Dermoscopy; D005260:Female; D015616:Histiocytosis, Non-Langerhans-Cell / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged
D003879:Dermatologic Agents; D008727:Methotrexate