Yellowish nodular changes in infants – juvenile xanthogranuloma and xanthoma

Juvenile xanthogranuloma (JXG) is the most often occurring representative of a very rare group of disorders classified as non-Langerhans cell histiocytosis. It is most frequently diagnosed in children patients under the age of 1 year, but it can occur in every age group [1–4]. The character of the lesions is usually benign and of a very good prognosis, the changes often undergo spontaneous remission. Xanthomas appear as a result of cholesterol and triglyceride accumulation in the tissues, most often in the skin, subcutaneous tissue and tendon sheaths. It is usually directly connected with hypercholesterolemia or hypertriglyceridemia [5–9].
Both abovementioned skin disorders, xanthoma and juvenile xanthogranuloma, are classified within a very wide group of cutaneous changes called xanthodermatoses. The most important characteristic of this group, easily distinguished during physical examination, is yellowish colour of the lesions that is a result of a substance accumulating in the skin (e.g. lipids) characterized by visible light reflection at wavelengths of 570–590 nm [10].
A 7-month-old girl sought medical attention in an outpatient dermatology clinic because of yellowish nodular changes located on her left cheek, on the brachial region – a lesion on the right arm, on the back and in the groin area. The lesions persisted for more than 3 months and the last change was noticed in the groin area 7 days before the medical appointment. During physical examination the occurrence of dome-shaped, well-demarcated, several millimetres in diameter, painless and non-itching nodules was observed. Besides, the girl was suffering from no other disorders, was taking no medications permanently and was under no medical specialist’s care. The child was caesarean-born in the first pregnancy and received 10 points in APGAR score. The mother was taking dydrogesterone during pregnancy because of a threatened miscarriage. A sample of the skin was obtained from the child’s lesion and on the basis of the outcome of histopathological examination, xanthogranuloma juvenile was diagnosed. The girl was also referred to an ophthalmological and paediatric clinic to undergo further diagnostic tests that excluded any extracutaneous lesions.
A 7-month-old boy was admitted to hospital to undergo diagnostic evaluation of six skin lesions located on the head, neck, back and posterior brachial region. During physical examination well-circumscribed, several millimetres...


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