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The skin lesions of cutaneous Rosai-Dorfman disease show a dense cellular infiltrate of histiocytes and lymphocytes in the dermis and subcutis. In addition, there may be plasma cells, neutrophils, and eosinophils. The infiltrate may have a nodular pattern. Some cases show stromal fibrosis with a storiform pattern.

Emperipolesis is not conspicuous. Ulceration, necrosis, cytologic atypia, increased mitotic activity, and granulomas are not present. Rare cases may show reactive lymphoid follicles.

Image 27 of 53