Histiocytic medullary reticulosis (HMR) is a rare, uniformly fatal, acute disease of the reticuloendothelial system. The disease is associated with fever, purpura, jaundice, hepatosplenomegaly, lymphadenopathy, and pancytopenia. A patient with HMR is described who had multiple, brown-to-violaceous tumors and plaques in the skin. A biopsy taken from a skin lesion showed the unique histologic finding of HMR, ie, phagocytosis of erythrocytes, platelets, and nuclear debris, by large, atypical histiocytes.
Engstrom PF, Aeling JL, Suringa DWR. Histiocytic Medullary Reticulosis With Cutaneous Lesions. Arch Dermatol. 1972;106(3):369-371. doi:10.1001/archderm.1972.01620120053011