case_images: PMC6503601_01
case_images: Multiple brown, skin-color, and yellowish waxy xanthelasma-like papules on
  the (a) left axilla. (b) Right eyelid. (c) Peribucal region.
case_images: 10.1177_2050313X19845217-fig1.jpg
case_images: PMC6503601_01_10.1177_2050313X19845217-fig1.jpg
case_images: fig1-2050313X19845217
case_images: On her June 2015 follow-up, there were new erythematous papules (0.2-1 cm in size) on her torso, axilla, and superior and inferior lips (Figure 1).
case_images: Histopathological examination of an abdominal skin lesion composed of a dense
  upper dermis nodular infiltrate consisting of histiocytes with
  multinucleated giant cells. (a) Hematoxylin-eosin stain (magnification 10x).
  (b) CD68+ histiocytes (magnification 10x). (c) S100- histiocytes
  (magnification 10x). (d) CD1a- histiocytes (original magnification,
  10x).
case_images: 10.1177_2050313X19845217-fig2.jpg
case_images: PMC6503601_01_10.1177_2050313X19845217-fig2.jpg
case_images: fig2-2050313X19845217
case_images: A third skin biopsy was done, and the histopathology was identical to her previous biopsies (Figure 2).
case_images: Bone marrow biopsy showing a dense infiltrate composed of histiocytes with
  multinucleated giant cells (hematoxylin-eosin stain, magnification 40x).
case_images: 10.1177_2050313X19845217-fig3.jpg
case_images: PMC6503601_01_10.1177_2050313X19845217-fig3.jpg
case_images: fig3-2050313X19845217
case_images: Touton-like giant cells (Figure 3). The histiocytes were positive for CD68, and negative for CD1a, S100, CD34, Factor XIIIa, and BRAF-V600E mutation.