Ulcerated juvenile xanthogranuloma of the scalp

Abstract

A 7-month-old girl presented with a single rapidly enlarging thickly crusted lesion on her frontal scalp. Histology was consistent with a juvenile xanthogranuloma (JXG) with ulceration and surface crust formation. Reports of ulcerating, crusted lesions of JXG are rare and the few reports have been confined to giant forms or those involving mucosal sites. This unusual presentation delayed diagnosis. Our report highlights the great variability in clinical presentation of JXG and is a reminder to consider this diagnosis in the differential of any lesion developing in an infant, particularly on the head, neck and upper trunk.

Imaging Features of Juvenile Xanthogranuloma of the Pediatric Head and Neck

“…2 Extracutaneous HN JXG has been reported in locations such as the tympanic membrane, nasal cavity, tongue, orbit and paranasal sinus, subglottis, cervical spine, skull base including the temporal bone, intracranial compartment, and HN muscles. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Cutaneous JXG typically presents as a solitary macule or papule with a flesh-colored, erythematous, or yellowish hue. 2 In such cases, radiographic imaging is not indicated.…”

Giant Cutaneous Horn on the Forearm of a Neonate

“…Our patient presented with a macronodular, crusted, horn‐like tumor with an atypical clinical appearance and location for a juvenile xanthogranuloma. A similar case has been described with a horn‐like crust superimposed on a flesh‐colored nodule on the scalp (7).…”

Neonatal Scalp Juvenile Xanthogranuloma

“…Observation or simple tumor excision is the treatment of choice [7]. Behne and Casey [8] reported that 7-month-old girl had 1.4 cm sized ulcerated JXG with 6 weeks growing period. Numajiri et al [9] reported recurrent 21 mm sized JXG of 9-month girl with growing duration of 5 months.…”