Abstract: A 65-year-old man presented with hands papulonodular and arthritis for over 3 months. Histopathology examination showed many histocytes and multi-nucleated giant cells with eosinophilic cytoplasm and a ground-glass cytoplasm in the dermis. PAS staining was positive. Immunohistochemistry showed Vimentin (+), CD68 (+), CD1a (-), S100 (-). The diagnosis of multicentric reticulohistiocytosis was made. The patient was treated with oral methylprednisolone, methotrexate and tripterygium wilfordii. The rash and joint symptoms improved significantly.