Diverse cutaneous manifestation of Langerhans cell histiocytosis: a 10-year retrospective cohort study

Abstract

Cutaneous manifestation is a common presentation of LCH and is usually a leading clue for the disease diagnosis. Having cutaneous lesions did not show a significantly early age onset at diagnosis compared to those without skin lesions, P value = 0.71. In the present study, cutaneous findings were found as 77.7%. Seborrheic dermatitis-like lesions were the most common cutaneous type (42.8%), followed by papules/nodules/masses (28.5%), petechiae/hemorrhagic lesions (17.8%), and eczematous lesions (10.7%). Time to diagnosis of LCH presented with seborrheic dermatitis-like lesions was significantly longer than other cutaneous presentations, P value = 0.0011.

Conclusion: Patients with LCH who had the manifestations of seborrheic dermatitis-like lesions can have diagnosis delayed due to the difficulty in distinguishing these lesions from normal seborrheic dermatitis lesions. Petechiae/hemorrhagic cutaneous signs in addition to the normal seborrheic dermatitis is the clue for early detection of the disease. To improve early detection of LCH, general pediatricians should be alerted to be aware of these skin symptoms, and if they persist, a dermatologist, pediatric if available, should be immediately consulted.

What is Known?
Cutaneous manifestation is a common presentation of LCH and is usually a leading clue for the disease diagnosis.
What is New?
Patients with LCH who have the manifestations of seborrheic dermatitis-like lesions can have a delayed diagnosis due to the difficulty in distinguishing normal from seborrheic dermatitis lesions.
Petechiae/hemorrhagic cutaneous signs in addition to the normal seborrheic dermatitis are the clue to the early disease detection.

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Abbreviations

LCH :

Langerhans cell histiocytosis

S-S LCH :

Single-system Langerhans cell histiocytosis

M-S LCH :

Multisystem Langerhans cell histiocytosis

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Acknowledgements

We would like to acknowledge Prof. James Arthur Will, for editing the manuscript via publication clinic KKU, Thailand.

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Authors

Contributions

L. Techasatian contributed to the conception and design of the study, data analysis, interpretation of findings, drafting the article, revising the article, and final approval of the version submitted. S. Poompuen contributed to study conception and data collection. J. Chaiyarit contributed to data processing and data analysis, critical revision of the article, and final approval of the version submitted.

Corresponding author

Correspondence to Leelawadee Techasatian.

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Ethical approval and informed consent

The study was approved by the institutional review board of Faculty of Medicine, Khon Kaen University, Thailand (IRB no. #HE591399), before enrolling any participants.

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The authors declare that they have no conflict of interest.

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Poompuen, S., Chaiyarit, J. & Techasatian, L. Diverse cutaneous manifestation of Langerhans cell histiocytosis: a 10-year retrospective cohort study. Eur J Pediatr 178, 771–776 (2019). https://doi.org/10.1007/s00431-019-03356-1

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Keywords

  • Langerhans cell histiocytosis
  • LCH
  • Seborrheic dermatitis
  • Petechiae
  • Hemorrhagic lesions