1
|
Guo MMH, Chen CC, Chen FS, Huang HC, Chung MY, Chen IL, Lin SH, Ou-Yang MC, Hsiao CC. A case of congenital Langerhans cell histiocytosis with disseminated skin and pulmonary involvement masquerading as multiple infantile hemangiomas. Pediatr Neonatol 2017; 58:552-554. [PMID: 28552247 DOI: 10.1016/j.pedneo.2017.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 04/28/2017] [Indexed: 11/18/2022] Open
Affiliation(s)
- Mindy Ming-Huey Guo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taiwan
| | - Chih-Cheng Chen
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taiwan
| | - Feng-Shun Chen
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taiwan
| | - Hsin-Chun Huang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taiwan
| | - Mei-Yung Chung
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taiwan
| | - I-Lun Chen
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taiwan
| | - Shang-Hung Lin
- Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taiwan
| | - Mei-Chen Ou-Yang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taiwan.
| | - Chih-Cheng Hsiao
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taiwan.
| |
Collapse
|
2
|
Morgan KW, Callen JP. Self-Healing Congenital Langerhans Cell Histiocytosis Presenting as Neonatal Papulovesicular Eruption. J Cutan Med Surg 2016. [DOI: 10.1177/120347540100500605] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Congenital self-healing Langerhans cell histiocytosis (CSHLCH) is a rare condition which may present at birth or during the neonatal period. It is usually characterized by the eruption of multiple, disseminated, red-brown papules and nodules which may increase in size and number during the first few weeks of life. Systemic signs are usually absent except for occasional mild hepatomegaly. Objective: We present a 3.5-kg male infant who presented at birth with numerous diffuse, erythematous, crusted erosions. He was presumed to have congenital herpes simplex virus (HSV) and was started on IV acyclovir. Histopathologic examination revealed a mixed inflammatory infiltrate with numerous histiocytes which were S-100 and peanut agglutin positive consistent with CSHLCH. Further workup did not reveal any signs of systemic involvement. Conclusion: CSHLCH has rarely been reported to present as a papulovesicular eruption at birth. In these cases, a viral etiology is commonly entertained in the differential diagnosis. Despite the spontaneous regression of skin lesions in CSHLCH, close followup is required to evaluate for systemic signs and symptoms associated with latent Letterer–Siwe disease.
Collapse
Affiliation(s)
- Kelli W. Morgan
- Department of Medicine, Division of Dermatology, University of Louisville, Louisville, Kentucky, USA
| | - Jeffrey P. Callen
- Department of Medicine, Division of Dermatology, University of Louisville, Louisville, Kentucky, USA
| |
Collapse
|
3
|
Brazzola P, Schiller P, Kühne T. Congenital self-healing langerhans cell histiocytosis with atrophic recovery of the skin: clinical correlation of an immunologic phenomenon. J Pediatr Hematol Oncol 2003; 25:270-3. [PMID: 12621251 DOI: 10.1097/00043426-200303000-00018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The pathophysiology and pathogenesis of congenital self-healing Langerhans cell histiocytosis (CSHLCH) as well as that of the other types of Langerhans cell histiocytosis is not well understood. Some authors postulate deregulated immunologic mechanisms that result in overproduction of cytokines. We examined a neonate with disseminated papulonodular eruptions containing lymphoid aggregates of B lymphocytes in the chorial layer. The diagnosis of a CSHLCH was made and the follow-up showed a complete involution of the eruptions, leaving atrophic lesions in the sites corresponding to the initial findings. We discuss a possible imbalance of the immune response as a pathogenetic mechanism.
Collapse
|
4
|
Affiliation(s)
- V Dragos
- Department of Dermatology and Children's Hospital, Medical Centre Ljubljana, Slovenia
| | | | | |
Collapse
|
5
|
Shy SW, Lee WH, Chang YC, Wu W. A solitary congenital self-healing histiocytosis. Report of a case and review of the literature. Pathol Res Pract 1996; 192:869-74; discussion 875-6. [PMID: 8897523 DOI: 10.1016/s0344-0338(96)80064-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Congenital self-healing histiocytosis (CSHH), and especially the solitary variant, is a rare primary skin disorder. We report on a newborn with a congenital solitary ulcerated skin nodule. Extracutaneous involvement was not found. A skin biopsy was performed at the age of 44 days and revealed a dense dermal infiltrate of large histiocytic cells. Immunohistochemical study revealed that the cells of the dermal infiltrate were Langerhans' cells which were strongly positive for S- 100 and negative for lysozyme, leukocyte common antigen and alpha-1-antichymotrypsin. The skin lesion involuted spontaneously over the next month without any treatment. The clinical, histopathological and immunohistochemical results fulfilled the criteria of solitary CSHH. We herein report the first case of CSHH in Taiwan and the twelfth case of solitary CSHH in the world.
Collapse
Affiliation(s)
- S W Shy
- Department of Pathology, Lotung Poh Ai Hospital, Yilan, Taiwan, Republic of China
| | | | | | | |
Collapse
|
6
|
Abstract
A case of the congenital self-healing reticulohistiocytosis variant of Langerhans cell histiocytosis is described. The child was born with a widespread blistering eruption, which rapidly resolved leaving papules and erosions. These ultimately healed leaving anetoderma. Congenital self-healing reticulohistiocytosis should be considered in the differential diagnosis of blistering eruptions present at birth.
Collapse
Affiliation(s)
- C R Higgins
- Department of Dermatology, Royal London Hospital, UK
| | | | | |
Collapse
|
7
|
Bernstein EF, Resnik KS, Loose JH, Halcin C, Kauh YC. Solitary congenital self-healing reticulohistiocytosis. Br J Dermatol 1993; 129:449-54. [PMID: 8217762 DOI: 10.1111/j.1365-2133.1993.tb03175.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Congenital self-healing reticulohistiocytosis (CSHR) was first described in 1973 by Hashimoto and Pritzker. Since then, both multiple and solitary forms have been described. We report a further case of solitary congenital self-healing reticulohistiocytosis. CSHR is a rare disorder which frequently presents a diagnostic dilemma in the newborn. Nodular forms of systemic Langerhans cell histiocytosis may present in a manner similar to CSHR. Because their differentiation on histopathological grounds is impossible, physical examination, laboratory investigations, and follow-up are necessary to ensure a lack of systemic involvement. Although previously thought to represent a rare variant of CSHR, solitary lesions of CSHR account for almost 25% of reported cases. A review of the literature relating to solitary CSHR, and a consideration of the differential diagnosis of a solitary congenital nodule, are also presented.
Collapse
Affiliation(s)
- E F Bernstein
- Thomas Jefferson University, Department of Dermatology, Philadelphia, PA 19107-5541
| | | | | | | | | |
Collapse
|
8
|
Hashimoto K, Kagetsu N, Taniguchi Y, Weintraub R, Chapman-Winokur RL, Kasiborski A. Immunohistochemistry and electron microscopy in Langerhans cell histiocytosis confined to the skin. J Am Acad Dermatol 1991; 25:1044-53. [PMID: 1687409 DOI: 10.1016/0190-9622(91)70305-l] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Four cases of benign Langerhans cell histiocytosis limited to the skin were studied. In all three self-healing cases (cases 2, 3, and 4) many dense bodies, myelin bodies, and worm bodies were found. In one chronic case (case 1) none of these was identified. In all four cases, in addition to CD1, HLA-DR, and S-100 stains, interferon-gamma and S-100 beta-subunit were positive in the dermal tumor cells. Both interferon-gamma and S-100 beta-subunits were negative in the normal epidermal Langerhans cells. A comprehensive literature review yielded 87 cases of skin-limited Langerhans cell histiocytosis. These cases could be subgrouped into three categories: (1) those that resolved spontaneously, (2) those that responded to therapy and had no recurrence, and (3) those with persistent or recurrent lesions, not responding to therapy but still limited to the skin.
Collapse
Affiliation(s)
- K Hashimoto
- Department of Dermatology and Syphilology, Wayne State University School of Medicine, Detroit, MI
| | | | | | | | | | | |
Collapse
|
9
|
Masouyé I, Chavaz P, Salomon D, Balderer J, Carraux P, Saurat JH. Solitary Langerhans cell histiocytoma: an unusual form of Hashimoto-Pritzker histiocytosis? Pediatr Dermatol 1990; 7:299-302. [PMID: 1964213 DOI: 10.1111/j.1525-1470.1990.tb01030.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A 2-month-old girl acutely developed a brownish, firm nodule on the left thigh. The lesion was surgically removed when the patient was age 3 months, and histology showed a massive dermal infiltration by large histiocytic cells with abundant ground glass cytoplasm. Most cells were S100 protein positive. Electron microscopic examination revealed the presence of Birbeck granules in about 30% of the histiocytes, as well as laminated dense bodies and wormlike bodies. No recurrence was observed during follow-up for three years. We believe that this case, like the one previously reported, represents a clinical variant of Hashimoto-Pritzker disease.
Collapse
Affiliation(s)
- I Masouyé
- Clinique de Dermatologie, Hôpital Cantonal Universitaire, Geneva, Switzerland
| | | | | | | | | | | |
Collapse
|