Juvenile Xanthogranuloma on the Palm

Abstract

Juvenile xanthogranuloma is a xanthomatous and granulomatous condition that frequently arises before 1 year of age and mainly occurs on the head and trunk. We report a rare solitary juvenile xanthogranuloma on the right palm of a 10‐year‐old girl, present for one year. This solitary involvement of the palm has been reported only twice before.

Case series of volar juvenile xanthogranuloma: Clinical observation of a peripheral rim of hyperkeratosis

“…Whereas JXG on the head, neck and trunk often appears yellowish, previous reports of volar JXG indicate that lesions can be erythematous, yellow-brown or dark brown. 6,[9][10][11] Indeed, our patients presented with lesions that were dull red (case 1) or flesh-colored (case 2). Given the unusual colors and locations of the lesions, we did not initially consider JXG in the clinical differential diagnosis, which for volar neoplasms include eccrine poroma, 11 pyogenic granuloma, 9,10 digital fibrokeratoma, 12 dermatofibroma, 6 nevi, viral verruca, amelanotic melanoma 13 and solitary reticulohistiocytoma.…”

“…We present two patients who developed volar JXG, which is very rare. [5][6][7][8][9][10][11] Previous reports indicate that volar JXG may occur in a solitary fashion. [9][10][11] Consistent with these observations, our patients had solitary lesions without evidence of JXG at other cutaneous or extracutaneous sites, such as the eye.…”

“…Given the unusual colors and locations of the lesions, we did not initially consider JXG in the clinical differential diagnosis, which for volar neoplasms include eccrine poroma, 11 pyogenic granuloma, 9,10 digital fibrokeratoma, 12 dermatofibroma, 6 nevi, viral verruca, amelanotic melanoma 13 and solitary reticulohistiocytoma. 6 Thus, histological evaluation is often necessary to diagnose volar JXG. Early lesions of JXG are composed of a dense dermal infiltrate of histiocytes lipidized to differing degrees and lacking Birbeck granules on ultrastructural examination, while mature lesions additionally contain Touton giant cells and other inflammatory cells, such as lymphocytes, eosinophils and neutrophils.…”

Solitary Tumor on the Palm of a Young Boy

“…The differential diagnosis of a solitary nodule on the palm includes eccrine poroma, pyogenic granuloma, tufted angioma, dermatofibroma, nevi, verruca, amelanotic melanoma, and solitary reticulohistiocytoma . This case demonstrates that although volar JXGs are rare, they should be added to the differential for solitary acral nodules in the appropriate clinical setting.…”

Xanthogranulomas associated with hematologic malignancy in adulthood

“…While an axial distribution is common in both age groups, juvenile xanthogranulomas have been reported to appear at other body sites, including the penis, thigh, subungual finger, palms, soles, and viscera. [18][19][20][21][22][23] Our case is unique for several reasons. The patient's location of residence, immunocompromised state, and molluscum contagiosumelike lesions increased our suspicion for infection with C immitis.…”