Letterer-Siwe Disease. Presented by William E. Bailey, MD.
An 8-month-old white girl has had an eruption in her groin and axillae since about 1 month of age. Three months ago this eruption was macerated, papular, erythematous, and accompanied by granulomas about 2 cm long and 0.5 cm wide in the axillae and inguinal folds. These granulomas yielded pseudohyphae on a KOH preparation; and a yeast was cultured. When nystatin and amphotericin B topically was applied the granulomas disappeared, and the papular appearance became obvious. Also, the papular scalp and abdomen eruptions began to develop in the past two months, as did the fluctuant mass on the scalp.The significant findings on physical examination were as follows: (1) a 3 cm in diameter fluctuant mass on the left frontal area of the scalp; (2) a crusted erythematous papular eruption of the trunk, intertriginous areas, and scalp; (3) hepatosplenomegaly.
Becker SW, Haeberlin JB. CHICAGO DERMATOLOGICAL SOCIETY. Arch Dermatol. 1967;95(5):537-542. doi:10.1001/archderm.1967.01600350099019