Xi Nan Hospital identifies a case with rarely seen
A rarely seen case of skin disease with the history of 12 years was confirmed as "generalized eruption type of histiocyte hypertrophy (tumor)", in the department of dermatology, Southern West Hospital, the third Military Medical University, Chongqing.
In 1990, scattered small papular rash occurred over the patient's face. The papules gradually increased in number and spread all over the body, some had the sizes of the broad bean. He had skin biopsy for many times in other hospitals, and the diagnosis was considered as leprosy or some other disease, which failed to respond to steroid treatment. Drs. Liu Rongqing, Ye Qingyi et al of the department of dermatology, Southwestern hospital performed biopsy at the patient's back, chest, and the frontal region, and studied with multiple acid fast stains without the discovery of leprosy bacillus. Histopathological and immunohistochemical analysis revealed large number of histiocytes hypertrophy in the dermis layer; however, they were not the foam cells as could be seen in cases of leprosy. Under electron microscope, multiple compact granules without membrane coating and helminth like corpuscles were seen. It was then confirmed that the diagnosis was generalized eruption type histiocyte hypertrophy(tumor).
According to the opinion of the department head, professor Hao Fei, this disease was very seldom seen and was easily to be misdiagnosed. In addition to the clinical manifestations of the generalized scattered nodular lesions, an accurate diagnosis of this condition should be based on the results of pathological examination of the skin biopsy specimen, immunohistochemical evaluation and observation of the microstructures under the electron microscope, as well as ruling out leprosy, lymphoma, xanthoma etc. As reported in the literature, this disease had the tendency of spontaneous cure, however, the reported case failed to have spontaneous disappearance of the lesion during a period of 12 years, and had brought tough problems for the final accurate diagnosis. The first case of this disease in the world was described in 1963, and the first case in China was seen in Fujian province in 1999., http://www.100md.com
In 1990, scattered small papular rash occurred over the patient's face. The papules gradually increased in number and spread all over the body, some had the sizes of the broad bean. He had skin biopsy for many times in other hospitals, and the diagnosis was considered as leprosy or some other disease, which failed to respond to steroid treatment. Drs. Liu Rongqing, Ye Qingyi et al of the department of dermatology, Southwestern hospital performed biopsy at the patient's back, chest, and the frontal region, and studied with multiple acid fast stains without the discovery of leprosy bacillus. Histopathological and immunohistochemical analysis revealed large number of histiocytes hypertrophy in the dermis layer; however, they were not the foam cells as could be seen in cases of leprosy. Under electron microscope, multiple compact granules without membrane coating and helminth like corpuscles were seen. It was then confirmed that the diagnosis was generalized eruption type histiocyte hypertrophy(tumor).
According to the opinion of the department head, professor Hao Fei, this disease was very seldom seen and was easily to be misdiagnosed. In addition to the clinical manifestations of the generalized scattered nodular lesions, an accurate diagnosis of this condition should be based on the results of pathological examination of the skin biopsy specimen, immunohistochemical evaluation and observation of the microstructures under the electron microscope, as well as ruling out leprosy, lymphoma, xanthoma etc. As reported in the literature, this disease had the tendency of spontaneous cure, however, the reported case failed to have spontaneous disappearance of the lesion during a period of 12 years, and had brought tough problems for the final accurate diagnosis. The first case of this disease in the world was described in 1963, and the first case in China was seen in Fujian province in 1999., http://www.100md.com