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Spontaneous Remission Of Multi-system Histiocytosis X

Broadbent et al., 8371Other/Unknown

Lancet 1(8371): Feb 4 1984; 253-254

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Abstract

Four neonates had solitary, congenital, rapidly growing, spontaneously ulcerating tumors of the face, trunk, and extremities. No extracutaneous involvement was found, and all lesions spontaneously involuted. Mononuclear cells of the cutaneous infiltrate were Langerhans’ cells. These findings expand the spectrum of congenital self-healing reticulohistiocytosis.

Case Details

Personal Characteristics

A 3-month-old girl, born to healthy unrelated pakistani parents

Clinical Characteristics

A rash had been present for 2 weeks. A generalised brown-red papular eruption over the trunk and scaly erythema of the scalp resembling “cradle-cap” were noted, but there was no lymphadenopathy, hepatosplenomegaly, or respiratory difficulty.

Remission Characteristics

Over the next 5 months the disease underwent spontaneous and complete remission. At age 2 years clinical examination, chest x-ray, and the t4:t8 ratio (1:1) were normal, and the child continued to make good general progress.

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Additional Notes

The diagnosis of HX was established by skin biopsy. After recovering rapidly from gastroenteritis, the baby thrived. Analysis of blood mononuclear cells showed a raised T4: T8 ratio of 3:1.