Abstract
Multicentric reticulohistiocytosis is characterized by the presence of papulonodular cutaneous eruption and arthropathy. If the onset of arthropathy precedes the eruption of skin lesion in a case, we may diagnose him with rheumatoid arthritis (RA) by mistake. We report a case of multicentric reticulohistiocytosis in an adult woman who had been diagnosed with RA first recognized in a skin lesion biopsy.
A 59-year-old woman with arthralgia in the bilateral knee and ankle following papulonodula in her face and fingers had been diagnosed with rheumatoid arthritis. However, she visited us because her arthritis had been getting worse. We made her consult a dermatologist about papulonodula and it was diagnosed as a skin lesion of multicentric reticulohistiocytosis by a biopsy. Radiography showed no findings. In a blood test, CRP was 2.89 mg/dl, rheumatoid factor was 78 IU/ml, erythrocyte sedimentation rate (ESR) was 61 mm/hr, antinuclear antibody test was positive, and value of anti SS-A autoantibody is high. We started treating her with prednisolone and auranofin, and her skin lesion and arthritis were improving. While malignancies of various types may develop in up to 18% of such cases, she has not had any malignant complications. Also, she has not had any autoimmune diseases. Without malignant complications, skin lesions may regress spontaneously after 5-10 years or more, but there may be residual joint impairment and we must follow up this case carefully.
