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Langerhans cell histiocytosis: an unusual cause of vesicular rashes in a neonate
  1. Liang Yi Justin Wee1,
  2. Alvin Ngeow2 and
  3. Mark Koh3
  1. 1Paediatric Medicine, KK Women's and Children's Hospital, Singapore
  2. 2Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore
  3. 3Department of Dermatology, KK Women’s and Children’s Hospital, Singapore
  1. Correspondence to Dr Alvin Ngeow; alvin.ngeow.j.h{at}singhealth.com.sg

Abstract

The skin manifestations of Langerhans cell histiocytosis (LCH) in the neonate have a heterogenous presentation and can mimic other causes of neonatal rashes. We report an uncommon case of LCH in a term female neonate presenting with non-specific papules and vesicles from the first day of life. There was a maternal history of genital herpes simplex virus (HSV) infection in the third trimester. Blood, cerebrospinal fluid, surface swabs and vesicular fluid were negative for HSV by PCR, and a skin biopsy confirmed the diagnosis of LCH. Further investigations for systemic involvement returned negative. Our case emphasises the variable and non-specific presentation of neonatal cutaneous LCH, which can progress to or be part of multisystem disease.

  • dermatology
  • paediatric oncology
  • neonatal health

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Footnotes

  • Contributors I was the primary physician who took care of the patient, supplied clinical photographs and jointly wrote the manuscript with Dr LYJW. Dr LYJW was the registrar on call who carried out the diagnostic workup for the patient and wrote the manuscript. Senior paediatric dermatologist Associate Professor MK provided advice on management, did the skin biopsy which ultimately led to the diagnosis of LCH, critically reviewed the manuscript and supplied histological images.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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