Vol. 21, No. 3, 2009
Received November 10, 2008, Accepted for publication December 24,
Reprint request to: Moon Kyun Cho, M.D., Department of Dermatology,
College of Medicine, Soonchunhyang University, 22, Daesagwan-gil,
Yongsan-gu, Seoul 140-743, Korea. Tel: 82-2-709-9368, Fax: 82-2-
709-9374, E-mail: MKCho2001@yahoo.co.kr
Ann DermatolVol. 21, No. 3, 2009
Fig. 1. Three brown lichenoid patches on left dorsal foot.
Langerhans Cell Histiocytosis Presenting as Brown
Hyuk Kwon, M.D., Jang Hyun Lee, M.D.1, Sung Keun Kim, M.D., Young Lip Park, M.D.,
Jong Suk Lee, M.D., Moon Kyun Cho, M.D.
Department of Dermatology, College of Medicine, Soonchunhyang University, Seoul, 1Department of Plastic and Reconstruction Surgery,
Hanyang University Guri Hospital, Guri, Korea
Langerhans cell histiocytosis (LCH) is related diseases
characterized by proliferation of Langerhans cell with
involvement of bone, skin, lung and other organs. LCH
usually occurs in childhood and are presented as multiple
small papules or eczematoid lesion mostly. We report a
50-year-old man with 3 brown lichenoid patches on left
dorsal foot. He was diagnosed pulmonary LCH 5 years ago.
Typical LC cells on skin lesion and CD1 complex positive
staining confirm the diagnosis of LCH. We consider brown
lichenoid patches may be a previously unreported
cutaneous presentation in cutaneous or multisystem LCH.
(Ann Dermatol 21(3) 277∼∼280, 2009)
Langerhans cell histiocytosis
Langerhans cell histiocytosis (LCH) is a rare, clinically
polymorphous group of disorders all having in common
proliferation of Langerhans cells. The recognized clinical
variants of LCH include Letterer-Siwe disease, Hand-
Schuller-Christian disease, eosinophilic granuloma, and
congenital self-healing reticulohistiocytosis1. We report a
50-year-old man with brown lichenoid patches, unusual
cutaneous presentation of LCH, on left dorsal foot.
A 50-year-old man attended Department of Dermatology
with a 2 year duration of brown-colored patches on the
left dorsal foot. Lobular consolidation was shown on chest
X-ray in health screening 5 years ago, but he had no
symptoms. He was diagnosed pulmonary LCH by chest
CT and percutaneous transthoracic needle aspiration. He
is a heavy smoker and has 45 pack-years smoking history.
On physical examination, there were three brown
lichenoid patches on left dorsal foot (Fig. 1). Any regional
lymph node is not palpable. His laboratory findings were
all within normal range. Initial chest CT showed lobular
consolidation at left basal segment of left lower lobe (Fig.
2). Regular enhanced chest CT in every 3 months revealed
no interval change in pulmonary LCH lesion. A biopsy
specimen of cutaneous lesion showed dense infiltrations
in the dermis and dermoepidermal junction. The infil-
trations consist of numerous histiocytes and few lymp-
hocytes. Histiocytes appear as large, round cells with
abundant cytoplasm and indented eccentric nucleus (Fig.