The Budding Scavenger-Juvenile Xanthogranuloma

 

Abstract

Juvenile xanthogranuloma is an uncommon, proliferative, non-Langerhans histiocytic cell disorder arising from dendrocytes. Juvenile xanthogranuloma is commonly discerned in childhood and demonstrates a male predominance. Of obscure aetiology, juvenile xanthogranuloma appears as a consequence of a hitherto uncharted infectious or physical stimulus which engenders a granulomatous histiocytic response. Typically, juvenile xanthogranuloma represents as an asymptomatic, solitary or multiple, firm, yellow, orange or brown papule or nodule. Cutaneous lesions demonstrate an intense infiltration of histiocytic cells within the superficial dermis. Histiocytic cells are intermingled with mature lymphocytes, plasma cells and eosinophils. Also, foam cells, foreign body giant cells and Touton giant cells emerge within mature lesions. Immune reactivity to CD68, vimentin, alpha-1 antichymotrypsin, lysozyme, Factor XIIIa, macrophage inflammatory protein (Ki-MIP) and anti-CD4 is observed. Juvenile xanthogranuloma mandates a segregation from benign and malignant conditions such as Langerhans cell histiocytosis, reticulohistiocytoma, embryonal rhabdomyosarcoma, atheroma, dermatofibroma, xanthoma or lipoma, Conservative management is recommended, and surgical eradication of cutaneous lesion is curative in lesions situated in accessible sites.

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