Cutaneous rosai-dorfman disease persisting after surgical excision: report of a case treated with acitretin

Katherine Fening, Mark Bechtel, Sara Peters, Matthew Zirwas, Kamruz Darabi
Journal of Clinical and Aesthetic Dermatology 2010, 3 (9): 34-6

OBJECTIVE: Cutaneous Rosai-Dorfman disease is rare, and there is a lack of literature on clinical evidence for treatment options. The objective of this report is to illustrate that acitretin may be effective in treating cutaneous Rosai-Dorfman disease.

DESIGN: A patient with cutaneous Rosai-Dorfman disease refractory to antibiotics, steroids, and surgical excision was treated with acitretin for a period of four months and was closely monitored for improvement in the lesion.

SETTING: This was a patient in the authors' medical dermatology clinic.

PARTICIPANTS: A single patient was involved.

RESULTS: The patient had continuous improvement in her cutaneous Rosai-Dorfman disease throughout a four-month treatment course with softening of the plaque and decreased erythema. She chose to discontinue treatment after four months due to hair loss with acitretin.

CONCLUSION: Cutaneous Rosai-Dorfman disease is a rare, benign, generally self-limited, lymphoproliferative disease of unknown etiology. It typically occurs as histiocyte-rich inflammatory infiltrates, manifesting as red papules and plaques in older women, without predilection for site. Treatment is usually unnecessary, unless the lesions persist and are bothersome to the patient or cause functional deficits. Treatments are based on case reports and include surgery, radiation, and medical options. Our experience with a patient with a case of cutaneous Rosai-Dorfman disease persisting after surgical excision demonstrates that acitretin may be an effective therapeutic option for cutaneous Rosai-Dorfman disease.

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