Langerhans cell histiocytosis in the elderly: a report of three cases.

Stefanato, C M; Andersen, W K; Calonje, E; Swain, F A; Borghi, S; Massone, L; Kowalski, J V; Bhawan, J · J Am Acad Dermatol · 1998

case_report · Level V

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Abstract

Langerhans cell histiocytosis is most common in children and is unusual in the elderly. We describe 3 cases of langerhans cell histiocytosis limited to the skin in elderly patients. Biopsy specimens showed a dermal infiltrate abutting the epidermis composed of atypical langerhans cells with abundant eosinophilic cytoplasm and a "kidney-shaped" nucleus. Immunoperoxidase stain CD1a was positive in all 3 cases and S-100 stain was positive in 2. Electron microscopy revealed Birbeck granules in the cytoplasm of the atypical langerhans cells in 2 cases. Langerhans cell histiocytosis with skin involvement has a chronic course with an overall good prognosis. However, cutaneous manifestations may precede systemic involvement by many years.

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