Langerhans cell histiocytosis: an unusual cause of vesicular rashes in a neonate

BMJ Case Rep. 2021 Dec 8;14(12):e247213. doi: 10.1136/bcr-2021-247213.

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.

Keywords: dermatology; neonatal health; paediatric oncology.

Publication types

  • Case Reports

MeSH terms

  • Biopsy
  • Exanthema* / etiology
  • Female
  • Histiocytosis, Langerhans-Cell* / complications
  • Histiocytosis, Langerhans-Cell* / diagnosis
  • Humans
  • Infant, Newborn
  • Skin
  • Skin Neoplasms*