García Muret M P, Fernández-Figueras M T, González M J, De Moragas J M
Dermatología, Clínica Quirón, Hospital de San Pablo, Barcelona.
Ann Dermatol Venereol. 1995;122(9):612-4.
The classification of Langerhans' cell histiocytosis into 5 forms does not cover all types of clinical presentations. We observed a patient with inborn Langerhans' cell histiocytosis involving the skin and bone tissue. The clinical course was benign during the first two years of the patient's life.
Skin lesions noted at birth resolved spontaneously but recurred twice in a more benign form. Histology examination showed "band" infiltration of the papillary derma composed of Langerhans' cells in direct contact with the basal epidermal layer and a few eosinophils. Immunolabelling was intensely positive for protein S100 confirming the diagnosis of Langerhans' cell histiocytosis. Extension was limited to a lytic lesion in the lower part of the left tibia which was treated by curettage.
In our opinion, Langerhans' cell histiocytosis covers a wide range of clinical presentations. Our case was remarkable because of the benign course despite its congenital nature and dissemination to skin and bone. Prolonged surveillance of Langerhans' cell histiocytosis is required for patients without any apparent prognosis factors.
朗格汉斯细胞组织细胞增多症分为5种形式的分类并未涵盖所有临床表现类型。我们观察到一名患有先天性朗格汉斯细胞组织细胞增多症的患者,累及皮肤和骨组织。在患者生命的头两年,临床病程呈良性。
出生时发现的皮肤病变自行消退,但以更良性的形式复发了两次。组织学检查显示乳头真皮层有“带状”浸润,由与基底表皮层直接接触的朗格汉斯细胞和少数嗜酸性粒细胞组成。免疫标记显示蛋白S100呈强阳性,证实了朗格汉斯细胞组织细胞增多症的诊断。病变仅局限于左胫骨下部的一个溶骨性病变,通过刮除术进行了治疗。
我们认为,朗格汉斯细胞组织细胞增多症涵盖了广泛的临床表现。我们的病例很特殊,因为尽管它具有先天性且累及皮肤和骨,但病程呈良性。对于没有任何明显预后因素的朗格汉斯细胞组织细胞增多症患者,需要进行长期监测。