The different dermoscopic features of the yellow background in Langerhans and non-Langerhans cells histiocytosis

Dermoscopy and reflectance confocal microscopy finding of different anatomic sites of Langerhans cell histiocytosis

BACKGROUND

Recognizing Langerhans cell histiocytosis (LCH) might be a challenge due to its rarity. Reflectance confocal microscopy (RCM) and dermoscopy were emergent promising non-invasive technique as auxiliary tools in diagnosis of different skin conditions. However, the RCM and dermoscopic features of LCH had been less investigated. To reveal the common RCM and dermoscopic features of LCH.

MATERIALS AND METHODS

Forty cases of LCH were retrospectively analyzed according to age, locations, clinical, RCM, and dermoscopic features from September 2016 to December 2022. To reveal the differences and common in clinical, RCM, and dermoscopic features that occur in different anatomic location.

RESULTS

In the study, sites of predilection include the trunk 31/40 (77.5%), extremity 21/40 (52.5%), face 14/40 (35%), scalp 11/40 (27.5%), vulvar 4/40 (10%), and nail 2/40 (5%). All LCHs had the common RCM features. There were significant differences in clinical and dermoscopic features for age and lesion anatomic site. The common dermoscopic features for scalp, face, trunk, and extremity were the erythematous scaly rash, purplish-red globules or patches, scar-like streaks with ectatic vessels. While the features for nail LCH were purpuric striae, onycholysis and purulent scaly rash, and the erosive erythematous plaque and purulent scaly rash for vulvar LCH. The common RCM features of all LCH showed a focal highly reflective dense image in the surface keratin layer, epidermis architectural disarray, obscuration of dermo-epidermal junction, numerous polygonal, large, medium reflective, short dendrites cells in the epidermis, and dermis. All LCH involving the vulvar and nail did not manifest skin lesions.

CONCLUSION

RCM and dermoscopy showed promising value for diagnosis and differentiation of LCH.

Multicentric Reticulohistiocytosis with Dermatomyositis-Like Features: A Case Report with Dermoscopy and Reflectance Confocal Microscopy Findings

Multicentric reticulohistiocytosis is an insidious-onset, non-Langerhans-cell histiocytosis affecting joints and skin. Early diagnosis is important to prevent destructive arthritis and disease-related complications. Reflectance confocal microscopy (RCM) is a technique that allows the visualization of the epidermis and superficial dermis non-invasively on a horizontal plane with quasi-histologic images of the skin. RCM features of non-Langerhans cell histiocytosis including Rosai-Dorfman disease, adult xanthogranuloma (AXG) and, juvenile xanthogranuloma (JXG) have been reported. However, RCM features of MRH have not previously been described. Herein, we present the RCM features of a case of MRH with dermoscopic and histopathologic features. This article is protected by copyright. All rights reserved.