Amouri M, Gouiaa N, Chaaben H, Masmoudi A, Zahaf A, Boudawara T, Turki H
Service de dermatologie, hôpital Hédi-Chaker, route El Ain km 1, 3029 Sfax, Tunisie.
Ann Dermatol Venereol. 2012 Feb;139(2):128-31. doi: 10.1016/j.annder.2011.10.408. Epub 2011 Dec 6.
Juvenile xanthogranuloma (JXG) is a form of self-healing non-Langerhans histiocytosis. We report a new case of disseminated JXG without visceral involvement but with positive immunostaining of the majority of histiocytes for protein S100.
A 6-month-old male infant was admitted to our department in January 2010 for congenital nodular lesions of varying size, shape and appearance. The remainder of the dermatological and physical examination was unremarkable. The diagnosis of disseminated JXG, strongly suggested clinically, was confirmed by a skin biopsy. However, immunohistochemistry was confusing, with positivity for protein S100. The lesions regressed spontaneously.
The aim of this case report is to highlight the lack of any forced association between alarming skin lesions of eruptive JXG and systemic involvement. The distinguishing feature of our case is the positive immunostaining for protein S100 in the histological section, which although rare in XJG, does not cast doubt on the diagnosis of non-Langerhans histiocytosis providing the clinical presentation is typical. Therapeutic abstention is the rule.
幼年性黄色肉芽肿(JXG)是一种自愈性非朗格汉斯组织细胞增多症。我们报告一例播散性JXG新病例,无内脏受累,但大多数组织细胞的蛋白S100免疫染色呈阳性。
一名6个月大的男婴于2010年1月因大小、形状和外观各异的先天性结节性病变入住我科。其余皮肤科和体格检查未见异常。临床强烈提示的播散性JXG诊断经皮肤活检得以证实。然而,免疫组化结果令人困惑,蛋白S100呈阳性。病变自行消退。
本病例报告的目的是强调爆发性JXG令人担忧的皮肤病变与全身受累之间不存在必然联系。我们病例的独特之处在于组织学切片中蛋白S100免疫染色呈阳性,这在XJG中虽罕见,但只要临床表现典型,就不影响非朗格汉斯组织细胞增多症的诊断。治疗上通常采取观察等待。