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Nail changes in Langerhans cell histiocytosis
1Skin Care Clinic, Darya Ganj, New Delhi, India.
Insights
Nail changes, including redness and swelling, are rare in Langerhans cell histiocytosis. Microscopic examination confirmed Langerhans cell collections, guiding treatment with antibiotics and steroids.
Area of Science:
- Dermatology
- Pediatric Pathology
Background:
- Langerhans cell histiocytosis (LCH) is a rare clonal proliferative disorder.
- Nail involvement in LCH is exceptionally uncommon, with limited documented cases.
Observation:
- The study reports a case of LCH presenting with distinct nail changes.
- Observed symptoms included paronychial erythema, swelling, and subungual pustules on fingernails and toenails.
Findings:
- Microscopic investigation revealed diffuse and dense collections of mononuclear Langerhans cells.
- Histopathological confirmation of LCH was established through tissue examination.
Implications:
- This case highlights the importance of considering LCH in the differential diagnosis of unusual nail abnormalities.
- Effective treatment involved a combination of systemic therapy (co-trimoxazole, cyclophosphamide, prednisolone) and topical agents.
Abstract:
Nail changes in Langerhans cell histiocytosis are distinctly uncommon. Paronychial erythema, swelling and subungual pustules of the fingernails and toenails were cardinal, and were supported by diffuse as well as dense collections of mononuclear Langerhans cells evidenced by microscopic investigation. Oral administration of co-trimoxazole (800 mg sulphamethoxazole + 160 mg trimethoprim) every 12 h, 50 mg/d cyclophosphamide and 80 mg/d predinisolone were the mainstay of treatment, supported by scalp tar shampoo and local betamethasone lotion application.