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Petechial and Red-Brown Papular Lesions in a 2-Year-Old Girl—Diagnosis
Arch Dermatol. 2007;143(8):1067-1072.
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Diagnosis: Langerhans cell histiocytosis (LCH).
MICROSCOPIC FINDINGS AND CLINICAL COURSE
Histopathologic examination of the biopsy specimen demonstrated superficial crust and hemorrhage, with an associated dermal infiltrate of cells containing abundant eosinophilic cytoplasm and a reniform or indented nucleus, characteristic of Langerhans cells (Figure 4, arrows), admixed with eosinophils. On immunohistochemical analysis, the cells were positive for S100 protein and CD1a antigen, findings that were consistent with a definitive diagnosis of LCH.
Figure appears in full text version.
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Investigation to identify the extent of the disease, including a complete blood cell count, liver function tests, computed tomography of the head, a whole-body bone scan, and chest radiography for thoracic involvement, was performed. The chest x-ray film showed extensive lung involvement. A follow-up computed tomogram of the chest showed diffuse bilateral cysts within the lungs, with little pulmonary parenchyma remaining. Vinblastine, prednisone, and methotrexate therapy was begun. Considerable skin improvement was noted after therapy was initiated; however, increased pulmonary problems subsequently developed, and the . . . [Full Text of this Article] DISCUSSION
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Petechial and Red-Brown Papular Lesions in a 2-Year-Old Girl—Quiz Case
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Arch Dermatol. 2007;143(8):1067-1072.
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