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Introduction: Multicentric Reticulohistiocytosis is a patology of unknown etiology with a poliarticular involvement, which typically involves the distal interphalangeal joints, associated with skin lesions consisting of nodules and papules symmetrically in the regions near the affected joints.
Clinical case: this is a 58-year female patient with a history of rheumatoid arthritis diagnosed 25 years ago, presents with a history characterized by papules, nodules, and vesicles symmetrically distributed at the level of the distal interphalangeal joints of the hand, as well on the elbows, knees, feet, back and face, as well as oral and anal mucosa. Also refers pain in the distal interphalangeal joints and knees, which also has edema of the joints. She presents a weight loss of 14 kilograms in 7 months, evening fever and occasional diarrhea predominance. A hand radiograph shows destruction of articular cartilage and bone erosions. The biopsy of the lesions shows a histiocytic infiltrate consistent with this pathology. Rheumatoid factor is positive.
Discussion: both skin lesions and the involvement of the distal interphalangeal joints, and constitutional symptoms are manifestations have been described in the literature of the Multicentric Reticulohistiocytosis. Although the definitive diagnosis is made by biopsy of the lesions, we must not forget that there is, in this particular case, a background Rheumatoid Arthritis, which can confuse the diagnosis and rarely associated with Multicentric Reticulohistiocytosis.
