Papular xanthomas and erosive arthritis in a 3 year old girl, is this a new MRH variant?

Catalina Matiz; Polly J Ferguson; Andrea Zaenglein; Brandt Groh; Catherine April Bingham

doi:10.1186/1546-0096-7-15

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Papular xanthomas and erosive arthritis in a 3 year old girl, is this a new MRH variant?

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Papular xanthomas and erosive arthritis in a 3 year old girl, is this a new MRH variant?

Catalina Matiz, Polly J Ferguson, Andrea Zaenglein, Brandt Groh and Catherine April Bingham

Pediatric rheumatology online journal, Vol.7(1), pp.15-15

10/08/2009

DOI: 10.1186/1546-0096-7-15

PMCID: PMC2770547

PMID: 19814780

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Abstract

Xanthomatous skin lesions and arthritis in children are not a common association. We present the case of a 3 year old girl who presented with xanthomatous lesions in the periungual region of both hands, around the nares and on her forehead, associated with significant arthritis that was clinically compatible with multicentric reticulohistiocytosis. However, pathology of the xanthomatous lesions was more suggestive of papular xanthoma, a disease that is not associated with arthritis. Based on her presentation and the negative lipid workup, she was treated for presumed multicentric reticulohistiocytosis. Multiple treatment strategies were utilized, with improvement on a combination of infliximab, methotrexate, and prednisone. We review the different diagnoses that should be considered in children with xanthomas and arthritis as well as the different pharmacologic therapies used in children with multicentric reticulohistiocytosis.

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Title: Subtitle: Papular xanthomas and erosive arthritis in a 3 year old girl, is this a new MRH variant?
Creators: Catalina Matiz - Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California, USA
Polly J Ferguson - Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
Andrea Zaenglein - Department of Dermatology, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
Brandt Groh - Division of Pediatric Rheumatology, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
Catherine April Bingham - Division of Pediatric Rheumatology, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
Resource Type: Journal article
Publication Details: Pediatric rheumatology online journal, Vol.7(1), pp.15-15
DOI: 10.1186/1546-0096-7-15
PMID: 19814780
PMCID: PMC2770547
NLM abbreviation: Pediatr Rheumatol Online J
ISSN: 1546-0096
eISSN: 1546-0096
Publisher: BioMed Central
Language: English
Date published: 10/08/2009
Academic Unit: Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Rheumatology, Allergy, and Immunology
Record Identifier: 9984065839702771

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