Cutaneous Rosai-Dorfman disease: a case report of disease limited only to skin

Rosai-Dorfman disease (RDD) is a disorder of histiocytic proliferation that can affect almost every organ. Skin may be involved in about 10% of cases, but only 3% of patients have skin lesions exclusively. Patients with cutaneous Rosai-Dorfman disease (CRDD) are usually healthy, without leading constitutional or other symptoms. The etiology of this disease is unclear, but it might be triggered by an infectious agent such as herpesvirus 6 (HHV-6) and Epstein-Barr virus (EBV). There is also a predisposition to autoimmune diseases and hematological malignancies. There is also a recognized predisposition to autoimmune disorders and hematologic malignancies. In our case, the patient was diagnosed with an infection due to Borrelia burgdorferi. To our knowledge, no previously reported association between B. burgdorferi infection and RDD has been described. The disease may manifest in any age group. The differential diagnosis includes Langerhans cell histiocytosis, metastasis, Hodgkin’s lymphoma, and other diseases. Disease usually resolves spontaneously over a period of months to years. Treatment should be administered in non-responsive or multiple relapsing cases. Also, it is very important to take into consideration the patient’s expectations and aesthetic appearance before making a treatment decision. Various treatment options are described, including surgical excision, cryotherapy, corticosteroids, antibiotics, methotrexate, and dapsone. In our case, we used CO₂ laser treatment successfully. To our knowledge, this is only the second case where CRDD lesions were treated successfully with CO₂ laser.