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Chasset F, Barete S, Charlotte F, Cohen-Aubart F, Arnaud L, Le Pelletier F, Emile JF, Francès C, Amoura Z, Haroche J. Cutaneous manifestations of Erdheim-Chester disease (ECD): Clinical, pathological, and molecular features in a monocentric series of 40 patients. J Am Acad Dermatol 2016; 74:513-20. [PMID: 26785805 DOI: 10.1016/j.jaad.2015.11.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/02/2015] [Accepted: 11/12/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis with possible cutaneous-specific involvement. OBJECTIVES We sought to describe the clinical, pathological, and molecular features of the cutaneous manifestations of 40 patients with ECD identified from a cohort of 123 patients. METHODS Confirmed cases of patients with ECD were included in a single-center retrospective observational study. Clinical and pathological cutaneous features were analyzed and BRAF(V600E) mutation was determined. RESULTS The most frequent ECD cutaneous manifestations were xanthelasma-like lesions (XLL), which occurred in 31 (25%) patients. Other ECD cutaneous lesions were patches or papulonodular lesions. Mixed form of ECD and cutaneous Langerhans cell histiocytosis presented with crusty papules of the folds in some patients. Compared with classic xanthelasma palpebrarum, ECD XLL pathology more frequently involved the reticular dermis, displayed more multinucleated or Touton cells, and showed less extensive fibrosis. BRAF(V600E) mutation was more frequently detected in patients with cutaneous involvement than in those without (76% vs 52%; P = .005) and constantly found in 10 XLL. LIMITATIONS Some clinical data were not available because of the retrospective design of the study. CONCLUSIONS XLL are the most frequent cutaneous ECD manifestations and might be targeted both for pathology and determination of BRAF mutational status.
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Affiliation(s)
- François Chasset
- E3M Institute, Service de Medecine Interne 2, French National Reference Center for Rare Systemic and Autoimmune Diseases, Assistance Publique Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Paris, France; Unit of Dermatology, Assistance Publique Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Paris, France; Department of Dermatology and Allergology, AP-HP, Hôpital Tenon, Paris, France
| | - Stéphane Barete
- Unit of Dermatology, Assistance Publique Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Paris, France; Department of Dermatology and Allergology, AP-HP, Hôpital Tenon, Paris, France; Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Université Paris VI, Paris, France
| | - Frédéric Charlotte
- Department of Pathology, Assistance Publique Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Paris, France; Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Université Paris VI, Paris, France
| | - Fleur Cohen-Aubart
- E3M Institute, Service de Medecine Interne 2, French National Reference Center for Rare Systemic and Autoimmune Diseases, Assistance Publique Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Paris, France; Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Université Paris VI, Paris, France
| | - Laurent Arnaud
- E3M Institute, Service de Medecine Interne 2, French National Reference Center for Rare Systemic and Autoimmune Diseases, Assistance Publique Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Paris, France; Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Université Paris VI, Paris, France
| | - François Le Pelletier
- Department of Pathology, Assistance Publique Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Paris, France; Tolbiac Pathology Department, Cabinet de Pathologie Tolbiac, Paris, France
| | - Jean-François Emile
- Department of Pathology AP-HP, Hôpital Ambroise Paré, Paris, France; EA4340, Université de Versailles, Versailles, France
| | - Camille Francès
- Department of Dermatology and Allergology, AP-HP, Hôpital Tenon, Paris, France; Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Université Paris VI, Paris, France
| | - Zahir Amoura
- E3M Institute, Service de Medecine Interne 2, French National Reference Center for Rare Systemic and Autoimmune Diseases, Assistance Publique Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Paris, France; Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Université Paris VI, Paris, France
| | - Julien Haroche
- E3M Institute, Service de Medecine Interne 2, French National Reference Center for Rare Systemic and Autoimmune Diseases, Assistance Publique Hôpitaux de Paris (AP-HP), Groupement Hospitalier Pitié-Salpêtrière, Paris, France; Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Université Paris VI, Paris, France.
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