Molluscum Contagiosum‐Like Presentation of Langerhans Cell Histiocytosis: A Case and Review

Abstract

Langerhans cell histiocytosis (LCH) is a rare disorder characterized by clonal proliferation of Langerhans cells in the skin. A molluscum-like presentation of cutaneous LCH is rare but important to consider for examination and management. We present an atypical molluscum-like LCH case and review the literature for common features of this unusual presentation.

Langerhans cell histiocytosis mimicking molluscum contagiosum: A case series

“…LCH skin involvement mimicking MC is exceptional, and only the following four cases have previously been described: a 4‐month‐old male and a 5.5‐month‐old female with localized low‐risk disease, an 18‐month‐old male with multisystem low‐risk disease, and a 2‐year‐old female with multisystem high‐risk disease (Table ). Hematoxylin‐eosin staining of a biopsy slide of LCH shows dermal mononuclear cell infiltration with reniform nuclei and eosinophilic cytoplasm, a positive staining for s100 and CD1a, some areas of epidermotropism, and a few eosinophiles.…”

“…Classical cutaneous LCH is characterized by scaly and erythematous papules and plaques localized on the scalp and diaper areas, mimicking seborrheic dermatitis 10 (Supplementary Figure S1). LCH skin involvement mimicking MC is exceptional, and only the following four cases have previously been described: a 4-month-old male 11 and a 5.5-month-old female 12 with localized low-risk disease, an 18-month-old male with multisystem low-risk disease, 13 and a 2-year-old female with multisystem high-risk disease 14 (Table 1).…”

Langerhans cell histiocytosis in an adult female with atypical swellings

“…Many unusual presentations have been reported like diffuse molluscum contagiosum-like umbilicated papules, ulcerative plaque and those mimicking lichen nitidus. [5][6][7] Our patient had pleomorphic lesions later proved to be of histiocytic origin, with the typical papules and crusts in seborrheic distribution and the atypical large swelling at the nape of the neck. The uncommon presentation and the rarity of the condition in adults caused it to evade detection for months.…”

“…Vinblastine/prednisolone has been used widely in pediatric patients with satisfactory results but owing to its rare occurrence in adults, its efficacy is not established. 6 Cytarabine, cladribine and etoposide have been tried in addition to conventional modalities like methrotrexate, azathioprine and thalidomide. 6 Also, radiotherapy has a role in selective cases of adults, as opposed to pediatric cases.…”

“…6 Cytarabine, cladribine and etoposide have been tried in addition to conventional modalities like methrotrexate, azathioprine and thalidomide. 6 Also, radiotherapy has a role in selective cases of adults, as opposed to pediatric cases. 6 More recently, vemurafinib, a tyrosine-kinase inhibitor, has been used albeit off-label, in a BRAF V600E positive, multi-refractory disease.…”