• Neeta Malviya, Alexander Marzuka, Mokhtar Maamed-Tayeb, Lu Le, and Travis Vandergriff.
• Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
• J. Cutan. Pathol. 2016 Dec 1; 43 (12): 1211-1214.

AbstractWe report the case of a patient with a long-standing history of extranodal, sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) and no evidence of original cutaneous involvement as well as a history of herpes zoster of the left flank with post-herpetic neuralgia who went on to develop multiple, round-to-oval, red-brown, atrophic macules and thin papules at the sites of herpes zoster scars on the left flank. Histopathology showed a dense nodular infiltrate of lymphocytes with some plasma cells and numerous large pale-staining histiocytes (S100+/CD68+), consistent with Rosai-Dorfman disease. This case showed exclusively cutaneous involvement, as demonstrated by otherwise normal physical examination, laboratory evaluation and imaging. This is the second reported case of Rosai-Dorfman disease occurring at the site of zoster scars, and to our knowledge this represents the first case report of cutaneous involvement of pre-existing Rosai-Dorfman disease via post-herpetic isotopic response (Wolf's isotopic response).© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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