PMC6503601_01
Multiple brown, skin-color, and yellowish waxy xanthelasma-like papules on
the (a) left axilla. (b) Right eyelid. (c) Peribucal region.
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On her June 2015 follow-up, there were new erythematous papules (0.2-1 cm in size) on her torso, axilla, and superior and inferior lips (Figure 1).
Histopathological examination of an abdominal skin lesion composed of a dense
upper dermis nodular infiltrate consisting of histiocytes with
multinucleated giant cells. (a) Hematoxylin-eosin stain (magnification 10x).
(b) CD68+ histiocytes (magnification 10x). (c) S100- histiocytes
(magnification 10x). (d) CD1a- histiocytes (original magnification,
10x).
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A third skin biopsy was done, and the histopathology was identical to her previous biopsies (Figure 2).
Bone marrow biopsy showing a dense infiltrate composed of histiocytes with
multinucleated giant cells (hematoxylin-eosin stain, magnification 40x).
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Touton-like giant cells (Figure 3). The histiocytes were positive for CD68, and negative for CD1a, S100, CD34, Factor XIIIa, and BRAF-V600E mutation.