Multifocal eosinophilic granuloma with skin ulceration. Histiocytosis X of the Hand-Schüller-Christian type.

A patient with multifocal eosinophilic granuloma or histiocytosis X of the Hand-Schüller-Christian type was diagnosed as having hidradenitis suppurativa on the basis of ulceration and draining sinuses of the axillary, perianal, and inguinal regions. He also had diabetes insipidus and thyroid and pulmonary disease. Microscopic examination of the thyroid, lungs, and involved skin indicated massive infiltration of these organs by histiocytes and eosinophils. Ulcerations of this type are a rare manifestation of Hand-Schüller-Christian disease. Surgical excision of the involved areas with healing by secondary closure produced good results.