Langerhans Cell Histiocytosis Presenting as Brown Lichenoid Patches

Abstract

Langerhans cell histiocytosis (LCH) is related diseases characterized by proliferation of Langerhans cell with involvement of bone, skin, lung and other organs. LCH usually occurs in childhood and are presented as multiple small papules or eczematoid lesion mostly. We report a 50-year-old man with 3 brown lichenoid patches on left dorsal foot. He was diagnosed pulmonary LCH 5 years ago. Typical LC cells on skin lesion and CD1 complex positive staining confirm the diagnosis of LCH. We consider brown lichenoid patches may be a previously unreported cutaneous presentation in cutaneous or multisystem LCH.

Case of Langerhans cell histiocytosis on soles

“…Skin involvement is common with LCH, and up to 50% of cases with multisystem disease may initially present with a rash, the intertriginous zones and lumbosacral areas being the most commonly affected. 2 A case of LCH presenting with lichenoid patches localized only on the dorsal foot has been reported, 3 but to our knowledge, our case is the first reported case of LCH with skin lesions confined to the soles. It is also possible that such lesions are the initial presentation of LCH.…”

“…Surgery, steroid cream, topical nitrogen mustard, interferon, interleukin, psoralen plus ultraviolet A therapy, excimer laser, isotretinoin and thalidomide can be used to treat the skin manifestations of LCH. 3,4 In more advanced disease, treatment may include combinations of systemic glucocortic-…”