Multicentric Reticulohistiocytosis (Lipoid Dermato-Arthritis)

Multicentric reticulohistiocytosis a review of eight cases

“…Well circumscribed erosions spread from joint margins to destroy surface articular cartilage and underlying bone, the eroded bone ends becoming separated by the thickened synovium which is involved in the infiltrative granulomatous process. Unlike rheumatoid arthritis, associated osteoporosis is minimal or absent in MR and the absence of periosteal reaction serves to distinguish the arthritis of MR from other erosive polyarthritides (Gold et al^ 1975)-No other polyarthritis is as rapidly destructive as MR and consequently 'end stage' arthritis mutilans is relatively common. In this series, two patients (Cases i and 2) eventually demonstrated the consequent deformity of their hands described as 'La main en lorgnette'.…”

Pink Papules on the Cheek

“…14 In addition, in the multicentric variant, similar lesions can affect any organ but there can be a proclivity to involve the hand and knee joints, leading to a crippling arthritis. 15 We presented a case of CRDD, a benign resident dendritic cell histiocytopathy that can manifest as a cutaneous confined process in the skin where the clinical course is characteristically benign. It potentially can be confused with LCH, indeterminate cell histiocytosis, xanthogranuloma, and reticulohistiocytoma.…”

Mutilating Arthritis

“…2 The former does not frequently involve distal interphalangeals joints and, unlike multicentric reticulohistiocytosis, characteristically associates marked osteoporosis, which may be one of the earliest manifestations. 2,4 The latter typically presents entheseal and periosteal new bone production, ill-defined or fuzzy margins, as well as an asymmetrical pattern of articular involvement. 2,4 Sometimes the presence of bone erosions with sclerotic margins can simulate a gouty process.…”

“…2,4 The latter typically presents entheseal and periosteal new bone production, ill-defined or fuzzy margins, as well as an asymmetrical pattern of articular involvement. 2,4 Sometimes the presence of bone erosions with sclerotic margins can simulate a gouty process. 2 However, gout does not usually have a symmetrical presentation and typically associates calcified tophi.…”

“…Radiologically, we should suspect it in cases of mutilating arthritis, differentiating it from rheumatoid or psoriatic arthritis 2 . The former does not frequently involve distal interphalangeals joints and, unlike multicentric reticulohistiocytosis, characteristically associates marked osteoporosis, which may be one of the earliest manifestations 2,4 . The latter typically presents entheseal and periosteal new bone production, ill-defined or fuzzy margins, as well as an asymmetrical pattern of articular involvement 2,4 .…”