Our study is consistent with previous reports in terms of clinical features of aphthous ulcers, related diseases, and family history of RAS, but no associated laboratory abnormalities were noted.

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Langerhans cell histiocytosis is a rare non-malignant disease with clinical heterogeneity. The disease may present with various clinical findings and may imitate many other conditions. In this report we describe a 34-monthold girl who presented with chronic otitis and otorrhea, skull fracture, rash, vulvar edema, erythema and erosion in labia majors which initially suggested child abuse but the patient was diagnosed with Langerhans cell histiocytosis.Key words: Langerhans cell histiocytosis, child abuse.Langerhans cell histiocytosis (LCH) is a myeloid cell-based neoplasm characterized by the reactive clonal increase of Langerhans cells and consisting of the components of autoimmune inflammatory disease 1 . Moreover, this disease is genetically related to BRAF-V600E gene mutation influencing the MAPK signaling pathway. Incidence rate is 8.9/million per year among children under the age of fifteen 2 . Potential symptoms encountered in LCH diagnosis in adults and children may also be observed in numerous diseases. Differential diagnosis is based on the presentation of typical histopathological findings or CD1a positive cells 3 .Tissue damage that was caused by someone else due to any reason is defined as physical abuse 4 . The awareness of conditions that simulate child abuse enables the ability to diagnose correctly. We presented a case of LCH mimicking child abuse in this report. Case ReportA 34-month-old girl was admitted to hospital with fever, rash, ear discharge and vaginal secretion. Medical history revealed crusted rash on the scalp and intertriginous areas and ear drainage from six months of age. Systemic and topical antibiotic treatments were prescribed several times with the diagnosis of acute otitis media and seborrheic dermatitis in other hospitals. At the age of one, laser polypectomy was performed through both of the external auditory canals. In addition to these complaints, vaginal secretion was observed for the last five months, and fever and rash were noted for the last five days. The patient, whose parents were third-degree relatives, had a one-year-old healthy sister.On physical examination, her general condition was moderate and she was apparently agitated. Remaining data about her physical examination were as follows; body temperature 38.1 °C, respiratory rate 24/min, pulse 101/min, arterial blood pressure 100/60 mm Hg. Apparent and locally yellowish clotted plaque was seen on the scalp, and broad erythematous skin was observed beneath it. Petechial-purpuric rashes were seen on the whole trunk and extremities. Bilateral external auditory canal was obliterated with polypoid lesion and purulent discharge. Purulent discharge, vulvar edema, erythema in labia majors, and local erosion were detected on intertriginous areas on the examination of genitourinary system. Other system examinations were normal.Routine laboratory investigations were as follows; hemoglobin (Hb) 8.9 gr/dl, white

Colchicine is an anti-inflammatory drug that has a narrow therapeutic index. Poisoning typically shows 3 phases with systemic symptoms. Gastrointestinal symptoms dominate in the first phase. Dermatologic manifestations usually appear, with skin eruptions in the second phase where multiorgan failure occurs and alopecia in the third phase where organ derangements resolve. Alopecia is a cardinal feature of the third phase, but there is no specifically defined eruption for toxication. Here, we report a case of colchicine intoxication in a 16-year-old girl with maculopapular/purpuric rash and alopecia.