“…The main causes for RDD remain uncertain, however, its association with viral (such as human herpes virus 6 and Epstein-Barr virus infections) and immune causes have been suggested (Gaul & Chang, 2019). In the classic pattern, affected patients manifest with bilateral cervical lymphadenopathy and frequently with intermittent fevers, night sweats, and weight loss (di Dio et al, 2016;Fang & Chen, 2015;Leal et al, 2013) which did not treat with thalidomide but later responded to methotrexate (Nadal, Kervarrec, Machet, Petrella, & Machet, 2015). Numerous cases of cutaneous RDD have been reported that their lesions were solitary without good response to treatment (Fang & Chen, 2015;Nadal et al, 2015;Sun, Shi, Su, Zhang, & Lu, 2018).…”