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Letterer-Siwe's Disease. Presented by Dr. Donald M. Pillsbury and (by invitation) Dr. John S. Strauss.
W. C., a white boy aged 16 months, presented a widespread erythematous, excoriated, purpuric, and crusted dermatitis. The crusts were dirty-yellow and fairly adherent. This dermatitis covered the whole back, almost the entire abdomen and chest, the palms, the periorbital areas, the scalp, the nares, and the ears.
The child was apparently in good health until the age of 4 months, when he developed an erythematous purpuric dermatitis of the trunk and scalp with vomiting which lasted for four days. Since then the patient's appetite has been poor and the severity of the cutaneous eruption has varied from time to time. The child was hospitalized at the Albert Einstein Medical Center, Northern Division, where the diagnosis of Letterer-Siwe's disease was made on the basis of roentgenographic evidence of osteolytic lesions in the skull and