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May 1959


AMA Arch Derm. 1959;79(5):611-617. doi:10.1001/archderm.1959.01560170109026

Letterer-Siwe Disease. Presented by Dr. Orlando Canizares.

A 17-month-old baby boy was referred to me by his pediatrician on Jan. 15, 1957, because of a perianal ulceration of six weeks' duration. There was an erosive lesion extending about 2 cm. around the anus. The lesion was rather superficial and showed evidence of secondary infection. There was also some crusting of the scalp. Since the patient had spent several months in Brazil, examinations for amebae and leishmaniae were carried out, with negative results. The lesion improved with antibiotic therapy, but it did not heal.

The child was seen again on July 26, presenting a peculiar eruption on the scalp, face, axillae, and groins. The lesions were scaly and crusted papules, 2 to 3 mm. in diameter, on apparently normal or slightly erythematous skin. A diagnosis of Letterer-Siwe disease was made clinically and confirmed by biopsy.

Prednisone, 5 mg.

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