Cutaneous involvement of pre-existing Rosai-Dorfman disease via post-herpetic isotopic response.
We report the case of a patient with a long-standing history of extranodal, sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) and no evidence of original cutaneous involvement as well as a history of herpes zoster of the left flank with post-herpetic neuralgia who went on to develop multiple, round-to-oval, red-brown, atrophic macules and thin papules at the sites of herpes zoster scars on the left flank. Histopathology showed a dense nodular infiltrate of lymphocytes with some plasma cells and numerous large pale-staining histiocytes (S100+/CD68+), consistent with Rosai-Dorfman disease. This case showed exclusively cutaneous involvement, as demonstrated by otherwise normal physical examination, laboratory evaluation and imaging. This is the second reported case of Rosai-Dorfman disease occurring at the site of zoster scars, and to our knowledge this represents the first case report of cutaneous involvement of pre-existing Rosai-Dorfman disease via post-herpetic isotopic response (Wolf's isotopic response).
Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Neeta
N
Malviya
Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Alexander
A
Marzuka
Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Mokhtar
M
Maamed-Tayeb
Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Lu
L
Le
Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Travis
http://orcid.org/0000-0001-6577-3838
T
Vandergriff
D002921:Cicatrix / Q000473:pathology; D006562:Herpes Zoster; D015618:Histiocytosis, Sinus / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000473:pathology*
Rosai-Dorfman; cutaneous; isotopic response; post-herpetic; zoster