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Osorio S, Harpain L, Jahn‐Bassler K, Tanew A, Radakovic S. Benign cephalic histiocytosis in a 2-year-old boy with an inconspicuous clinical presentation at onset. Clin Case Rep 2023; 11:e8043. [PMID: 37830061 PMCID: PMC10565099 DOI: 10.1002/ccr3.8043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023] Open
Abstract
We report on a 2-year-old boy whose initially inconspicuous skin lesions later on evolved into a typical clinical presentation of benign cephalic histiocytosis (BCH). The diagnosis of BCH can often be made on clinical grounds without the need for an extensive diagnostic work-up. Given the benign and self-limited course of the disease treatment is not required and the clinical management can be limited to a watchful waiting approach.
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Affiliation(s)
- Sandra Osorio
- Department of DermatologyMedical University of ViennaViennaAustria
| | - Lucie Harpain
- Department of DermatologyMedical University of ViennaViennaAustria
| | | | | | - Sonja Radakovic
- Department of DermatologyMedical University of ViennaViennaAustria
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Effendi RMRA, Rizqandaru T, Yuliasari R, Gondokaryono SP, Diana IA, Dwiyana RF. Successful Treatment of Non-Langerhans Cell Histiocytosis With Topical Rapamycin in Two Pediatric Cases. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2022; 15:1575-1582. [PMID: 35967913 PMCID: PMC9365013 DOI: 10.2147/ccid.s375995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/28/2022] [Indexed: 11/23/2022]
Abstract
Non-Langerhans cell histiocytosis (non-LCH) is a group of diseases characterized by the proliferation of histiocytes in tissues that is excluded from the diagnostic criteria for LCH. Juvenile xanthogranuloma (JXG) and benign cephalic histiocytosis (BCH) are the most common types of cutaneous non-LCH. These two diseases share similarities in both clinical and histological features, therefore, they can be difficult to differentiate. Thorough physical, dermoscopic, and histopathological examinations are required to distinguish between JXG and BCH. We hereby present two rare cases of non-LCH in pediatric patients, presented with JXG and BCH. The dermoscopic examination of both cases showed a setting-sun appearance, while the histopathological examination revealed Touton giant cells in the JXG case, and massive lymphocyte infiltration in the BCH case. Both patients were treated with 1% topical rapamycin in a split-side comparison for the first 12 weeks, followed by applications on both sides for a total duration of 24 weeks. As a result, there was a significant reduction in the size of the lesion, leading to patient’s satisfaction. Rapamycin is an immunosuppressive agent with antineoplastic activity. Rapamycin can be used as an alternative non-invasive topical treatment option for JXG and BCH. However, long-term observations are required to assess its effectiveness and side effects.
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Affiliation(s)
- Raden Mohamad Rendy Ariezal Effendi
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
- Correspondence: Raden Mohamad Rendy Ariezal Effendi, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Jl. Pasteur no. 38, Bandung, West Java, 40161, Indonesia, Tel +62 22 2032426, Email
| | - Trustia Rizqandaru
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Renata Yuliasari
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Srie Prihianti Gondokaryono
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Inne Arline Diana
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Reiva Farah Dwiyana
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia
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Brichta L, Carver JG, Carver DeKlotz CM. Topical sirolimus: Difference between compounded preparations and commercial oral solution. Pediatr Dermatol 2021; 38:967-969. [PMID: 34060128 DOI: 10.1111/pde.14637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Topical sirolimus has become a crucial treatment option for many dermatologic disorders. Because an FDA-approved topical formulation is not commercially available, sirolimus creams, ointments, and gels are professionally prepared by compounding pharmacies. Also, the topical use of a commercially available sirolimus solution approved for oral administration is described regularly. To better guide providers in their decision-making when topical sirolimus is being considered, this article highlights the substantial pharmaceutical and clinical differences between commercial oral solution and compounded preparations specifically designed for topical therapy.
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Affiliation(s)
- Lars Brichta
- Chemistry Rx Compounding and Specialty Pharmacy, Folcroft, PA, USA
| | - James G Carver
- Organic Chemistry, University of Alabama in Huntsville, Huntsville, AL, USA
| | - Cynthia Marie Carver DeKlotz
- Department of Dermatology, MedStar Washington Hospital Center/Georgetown University Hospital, Washington, DC, USA.,Georgetown University School of Medicine, Washington, DC, USA
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