<p>Juvenile Xanthogranuloma: Case Report and Literature Review</p>

Abstract

Juvenile Xanthogranuloma (JXG) is a relatively uncommon non-Langerhans cell histiocytosis, which often occurs at an early age and is usually asymptomatic. Herein, we present the case of a 17-year-old man with numerous asymptomatic yellow-brown papulonodular lesions with a symmetric distribution on upper and lower extremities, face, and trunk, developed over the past 4 years. In the histopathologic examination, histiocytes with a Touton-like appearance were observed in favor of xanthogranuloma. The patient was treated with isotretinoin 20 mg daily for 2 months, which surprisingly led to the progression of lesions and thus was discontinued. Although JXG may cause severe morbidities in some circumstances, it is a self-limiting benign disorder and patients should be assured regarding the benign self-regressive nature of the disease.

Multiple Xanthogranulomas in a Teenager

“…A 17-year-old male was treated with isotretinoin, which was discontinued after two months due to surprising lesion progression. Reduction in number and size of the lesions was observed after a year [6]. CO 2 laser was used in a case with no recurrence of the lesions after five years [3].…”

“…Most common locations of the lesions were on the extremities, trunk, and face. Treatment course varied among the cases [1,[3][4][5][6]. Routine follow-up was elected for two patients, given the benign nature of the disease and tendency for self-resolution [1,5].…”

“…Ophthalmology examination is recommended to avoid the significant morbidity associated with an extracutaneous lesion of the eye [1]. Surgical excision, CO 2 laser, and isotretinoin have been reported with variable response in the treatment of cutaneous lesions, and self-resolution is common in singular lesions, but more rare in multiple [2,3,6].…”

“…Clinical appearance and histology were consistent with the typical findings of JXG across all cases. Yellow to brown papules and nodules were the most frequently reported description of lesions [ 1 , 3 - 6 ]. No cases revealed pink to brown plaques as seen in our patient.…”

“…Routine follow-up was elected for two patients, given the benign nature of the disease and tendency for self-resolution [ 1 , 5 ]. Two patients were reported to have spontaneous regression of some lesions [ 5 , 6 ]. A 17-year-old male was treated with isotretinoin, which was discontinued after two months due to surprising lesion progression.…”