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Rosai – Dorfman disease is a disorder of histiocytic proliferation that can affect almost every organ. Skin may be involved in about 10% cases, but only 3% of patients have skin lesions exclusively. Patients with CRDD usually are healthy, without leading constitutional or other symptoms. Etiology of this disease is unclear, but it might be triggered by an infectious agent such as Herpesvirus 6 and Epstein-Barr virus, there is also predisposition to autoimmune diseases, hematological malignancies. In our case patient was diagnosed with Borrelia burgdorferi infection. Any known association between this infection and Rosai – Dorfman disease was not described before. The disease may manifest in any age group. The differential diagnosis includes Langerhans cell histiocytosis, metastasis, Hodgkin’s lymphoma and other diseases. Disease usually resolves spontaneously over a period of months to years. Treatment should be administered in non-responsive or multiple relapsing cases. Also, it is very important to take into consideration the patient’s expectations and aesthetic appearance before making a treatment decision. Various treatment options are described, including surgical excision, cryotherapy, corticosteroids, antibiotics, Methotrexate, Dapsone. In our case, we used CO2 laser treatment successfully. To our knowledge, this is only the second case where CRDD lesions were treated successfully with CO2 laser.

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Langerhans cell histiocytosis (LCH) is an idiopathic group of disorders characterized histologically by proliferation and infiltration of tissue by Langerhans cell-type histiocytes. This disease can affect various organs. Patients with single system lesion should be followed carefully. Detection of somatic BRAF-V600E mutation in circulating blood cells or in lesional biopsies has been associated with high-risk clinical characteristics. A 38-year old male presented to our Dermatology Centre with a 3 months history of small nodule on his right leg skin. Surgery to remove the lesion was performed. The diagnosis of skin-limited Langerhans cell histiocytosis was established. Due to possible systemic spread the patient was referred to a haematologist for further evaluation. Full body CT scan did not show any infiltrates in other organs. Bone marrow aspirate and biopsy was performed, no Langerhans cells were detected. Sometimes skin lesions may represent the most clinically evident manifestation of potentially life-threatening multisystem disease.