Publication:

A Solitary Nodule in the Palm of a Newborn

Learning Points

1. Skin-limited Langerhans cell histiocytosis (LCH) during the neonatal period with spontaneous clearing has been termed congenital self-healing reticulohistiocytosis.
2. As the course of this disease cannot be predicted and extracutaneous organ involvement can manifest later on, some authors prefer avoiding the use of this designation and instead refer to it as neonatal LCH with cutaneous involvement.
3. There are no clinical or morphological patterns that can distinguish between skin-limited and multisystem LCH (MS-LCH).
4. Classical neonatal LHC with cutaneous involvement are multiple, red-brown papules, nodules, or vesicles resembling a varioliform rash that may be crusted or ulcerated. However, a variety of cutaneous lesions have been described, including solitary nodules.
5. To determine the extent of organ involvement, a series of laboratory and imaging evaluations must be done, and there is a need for continued long-term follow-up for signs of MS-LCH.