Langerhans cell histiocytosis physical examination: Difference between revisions

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{{Langerhans cell histiocytosis}}
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==Overview==
Langerhans cell histiocytosis patients often appear [[cachexic|cachectic]]. Physical examination of patients with Langerhans cell histiocytosis is usually remarkable for scaly erythematous lesions located on the scalp and extremities, localized [[bone]] [[tenderness]], and [[hepatosplenomegaly]].<ref name="PDQ">Langerhans Cell Histiocytosis Treatment (PDQ®): Health Professional Version.  National Cancer Institute (2015) http://www.cancer.gov/types/langerhans/hp/langerhans-treatment-pdq Accessed on February, 3 2016</ref><ref name="wiki">Langerhans cell histiocytosis. Wikipedia (2015) https://en.wikipedia.org/wiki/Langerhans_cell_histiocytosis Accessed on February, 2 2016</ref>
==Physical Findings==
==Physical Findings==
[[Organs]] involved:
===General Appearance===
*Bone: Most frequent in both unifocal and disseminated disease presenting as painful swelling. Skull, long bone of upper extremity, flat bones are affected in descending order. Infiltration in hands and feet is unusual. Osteolytic lesions can lead to pathological fractures.
* Langerhans cell histiocytosis patients often appear [[cachexic|cachectic]]<ref>{{Cite journal
*Skin: Commonly present as rash which varies between scaly erythematous lesions to red papules pronounced in [[Intertrigo|intertriginous]] areas. Up to 80% of LS would have extensive eruptions on the scalp.
| author = [[Riccardo Haupt]], [[Milen Minkov]], [[Itziar Astigarraga]], [[Eva Schafer]], [[Vasanta Nanduri]], [[Rima Jubran]], [[R. Maarten Egeler]], [[Gritta Janka]], [[Dragan Micic]], [[Carlos Rodriguez-Galindo]], [[Stefaan Van Gool]], [[Johannes Visser]], [[Sheila Weitzman]] & [[Jean Donadieu]]
*Bone marrow : Pancytopenia with super added infection usually implies poor prognosis. Anemia can be due to number of factors and not necessarily implies bone marrow infiltration.
| title = Langerhans cell histiocytosis (LCH): guidelines for diagnosis, clinical work-up, and treatment for patients till the age of 18 years
*Lymph node: cervical commonest. enlargement of the liver in 20%, spleen in 30% and lymph nodes in 50% of HSC.<ref>{{cite web |url=http://www.patient.co.uk/showdoc/40002781/#notes |title=Langerhans cell histiocytosis - Patient UK |accessdate=2007-05-10 |format= |work=}}</ref>
| journal = [[Pediatric blood & cancer]]
*[[Endocrine]] glands:[[Hypothalamic-pituitary-adrenal axis|Hypothalamic pituitary axis]] commonly involved. Diabetes insipidus most common. [[Anterior pituitary]] [[hormone]] deficiency is usually permanent.
| volume = 60
*Lungs:
| issue = 2
*Less frequently GIT, CNS.
| pages = 175–184
| year = 2013
| month = February
| doi = 10.1002/pbc.24367
| pmid = 23109216
}}</ref>


===Vital Signs===
* Low-grade [[fever]]<ref>{{Cite journal
| author = [[Tetsuko Kobayashi]], [[Yuhki Koga]], [[Masataka Ishimura]], [[Kentaro Nakashima]], [[Wakako Kato]], [[Hiroaki Ono]], [[Motoshi Sonoda]], [[Katsuhide Eguchi]], [[Reiji Fukano]], [[Satoshi Honjo]], [[Yoshinao Oda]] & [[Shouichi Ohga]]
| title = Fever and Skin Involvement at Diagnosis Predicting the Intractable Langerhans Cell Histiocytosis: 40 Case-Series in a Single Center
| journal = [[Journal of pediatric hematology/oncology]]
| volume = 40
| issue = 3
| pages = e148–e153
| year = 2018
| month = April
| doi = 10.1097/MPH.0000000000001080
| pmid = 29293189
}}</ref>
===HEENT===
* Scaly erythematous scalp lesions
===Abdomen===
* [[Hepatomegaly]]
* [[Splenomegaly]]
===Extremities===
* Scaly erythematous [[cutaneous]] lesions
* Localized [[bone]] [[tenderness]]
==Gallery==
<gallery>
Image:Langerhans cell histiocytosis01.jpg|Langerhans cell histiocytosis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Langerhans cell histiocytosis02.jpg|Langerhans cell histiocytosis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Langerhans cell histiocytosis03.jpg|Langerhans cell histiocytosis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Langerhans cell histiocytosis04.jpg|Langerhans cell histiocytosis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Langerhans cell histiocytosis05.jpg|Langerhans cell histiocytosis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Langerhans cell histiocytosis06.jpg|Langerhans cell histiocytosis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
</gallery>
<gallery>
Image:Langerhans cell histiocytosis08.jpg|Langerhans cell histiocytosis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Langerhans cell histiocytosis09.jpg|Langerhans cell histiocytosis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Langerhans cell histiocytosis10.jpg|Langerhans cell histiocytosis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
</gallery>
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 00:15, 26 March 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]

Overview

Langerhans cell histiocytosis patients often appear cachectic. Physical examination of patients with Langerhans cell histiocytosis is usually remarkable for scaly erythematous lesions located on the scalp and extremities, localized bone tenderness, and hepatosplenomegaly.[1][2]

Physical Findings

General Appearance

  • Langerhans cell histiocytosis patients often appear cachectic[3]

Vital Signs

HEENT

  • Scaly erythematous scalp lesions

Abdomen

Extremities

Gallery

References

  1. ↑ Langerhans Cell Histiocytosis Treatment (PDQ®): Health Professional Version. National Cancer Institute (2015) http://www.cancer.gov/types/langerhans/hp/langerhans-treatment-pdq Accessed on February, 3 2016
  2. ↑ Langerhans cell histiocytosis. Wikipedia (2015) https://en.wikipedia.org/wiki/Langerhans_cell_histiocytosis Accessed on February, 2 2016
  3. ↑ Riccardo Haupt, Milen Minkov, Itziar Astigarraga, Eva Schafer, Vasanta Nanduri, Rima Jubran, R. Maarten Egeler, Gritta Janka, Dragan Micic, Carlos Rodriguez-Galindo, Stefaan Van Gool, Johannes Visser, Sheila Weitzman & Jean Donadieu (2013). "Langerhans cell histiocytosis (LCH): guidelines for diagnosis, clinical work-up, and treatment for patients till the age of 18 years". Pediatric blood & cancer. 60 (2): 175–184. doi:10.1002/pbc.24367. PMID 23109216. Unknown parameter |month= ignored (help)
  4. ↑ Tetsuko Kobayashi, Yuhki Koga, Masataka Ishimura, Kentaro Nakashima, Wakako Kato, Hiroaki Ono, Motoshi Sonoda, Katsuhide Eguchi, Reiji Fukano, Satoshi Honjo, Yoshinao Oda & Shouichi Ohga (2018). "Fever and Skin Involvement at Diagnosis Predicting the Intractable Langerhans Cell Histiocytosis: 40 Case-Series in a Single Center". Journal of pediatric hematology/oncology. 40 (3): e148–e153. doi:10.1097/MPH.0000000000001080. PMID 29293189. Unknown parameter |month= ignored (help)
  5. ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 "Dermatology Atlas".


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