Juvenile xanthogranuloma in Child
JXGs are usually solitary and most often appear at birth or within the first year of life. However, their number and size may increase over the first 18 months of life. Lesions usually regress over 3-6 years, leaving behind persistent pigmentary change or atrophy.
Systemic involvement is rare, with the most common site of extracutaneous involvement being the eye (0.3%-0.5%). Eye involvement is more common in patients with multiple JXGs. Many internal organs can potentially be involved, including the central nervous system, liver, lungs, muscles, oropharynx, and spleen. Cutaneous lesions are absent in one-half of cases with systemic involvement.
JXGs have been associated with neurofibromatosis type 1 (NF1), particularly in patients younger than 2 years of age. Additionally, a triple association between JXGs, NF1, and juvenile myelomonocytic leukemia has been observed in several case reports. In adults, the condition lasts longer and is more frequently associated with permanent changes in pigment and atrophy after spontaneous resolution.
D76.3 – Other histiocytosis syndromes
400031009 – Juvenile xanthogranuloma
Differential Diagnosis & Pitfalls
- Mastocytomas – Similar in color to JXGs, but they urticate when rubbed.
- Spitz nevi – Pigmented and do not regress over time.
- Xanthomas (eg, xanthoma disseminatum)
- Langerhans cell histiocytosis