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December 1971


Author Affiliations

Department of Dermatology Tohoku University School of Medicine Sendai, Japan

Arch Dermatol. 1971;104(6):684-685. doi:10.1001/archderm.1971.04000240108017

To the Editor.—  An autopsy case of Letterer-Siwe disease is presented in which multiple punched-out bone lesions were detected radiologically and studied histopathologically, and we wish to comment on the presence of the punched-out bone lesions in this disease.

Report of a Case  The patient was a 7-month-old female infant. At the age of 5 months, small reddish papules developed on the abdomen and gradually increased in number. About ten days before admission, intermittent diarrhea occurred, she ate poorly, cried constantly, and her general condition was poor. On examination, the child was pale, anemic, and inactive. Eruptions were present on the head, face, trunk, palms, soles, and mucous membranes of the mouth, consisting of hemorrhagic papules and ulcers of miliary to rice-grain size with scales or crusts. The liver and the spleen were both palpated. Lymphadenopathy was noted at the neck and inguinal regions. Laboratory examination showed low level of