Herpes simplex in a child with Langerhans cell histiocytosis type Hand-Schüller-Christian.

Abstract

A 25-month-old child hospitalized for diabetes insipidus in oncohematology was first observed due to an exudative lesion of the right cheek (Fig. 1) arisen from 3 days. On physical examination micropustular lesions with polycyclic outline led to the clinical diagnosis of recurrent herpes simplex. The Tzanck cytodiagnosis showed balloon cells, confirming the diagnosis. When aged 11 months the child had presented a left front tumefaction due to an underlying osteolytic lesion of 3 cm. The osteolytic tumor had been removed and the histological examination had led to diagnose Langerhans cell histiocytosis type eosinophilic granuloma of the bone (Fig. 2). Because of the presence of other osteolytic lesions chemotherapy with vinblastine for 6 months had been performed. After 3 months the child had relapsed with new osteolytic lesions, polydipsia and polyuria leading to resume therapy with vinblastine, prednisone, desmopressin.