PMC9345104_01
(a) Single yellowish plaque over medial side of the left and right eye (arrow), (b) subcutaneous swelling on flank (c) multiple yellowish to skin colored firm, non-tender papules and nodules measuring approximately 1-2 cm in size over dorsum of hands; (d) MRI pelvis revealed protruding well circumscribed soft-tissue lesions (arrow).
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F1
These lesions involved the knuckle, foot, lateral malleolus, gluteal region, and right and left upper eyelid and were associated with itching [Figure 1a-c].
(a) Cytosmears show clusters of foamy histiocytes in a proteinaceous background (Giemsa, x100), (b) lipid-rich background with many foamy histiocytes, upper right inset: Touton type giant cells (Giemsa, x400), (b and c) skin biopsy shows pan dermal infiltration by foamy macrophages (H and E, x100).
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F2
FNAC from nodular cystic swellings over the interphalangeal joint (knuckle) and bilateral gluteal swelling revealed similar findings comprising of predominantly foamy macrophages in clusters as well as scattered singly, multinucleated giant cells, few benign mesenchymal cells, and occasional inflammatory cells in a hemorrhagic background [Figure 2a and b]. Skin biopsy from lateral ankle lesion showed pan dermal infiltration by foamy macrophages [Figure 2c].