title: The natural history of skin-limited Langerhans cell histiocytosis: a single-institution experience.
abstract: BACKGROUND
  Prior reports of Langerhans cell histiocytosis (LCH) suggest that isolated skin involvement is rare and often progresses to systemic disease. More rapid access to pediatric subspecialty care has likely led to more frequent representation of this condition. The purpose of this study is to characterize the natural history of skin-limited LCH in an era of increased access to pediatric subspecialty care.
  
  
  METHODS
  A retrospective chart review was performed on all patients newly diagnosed with LCH between 2001 and 2012 at the Children's Hospital of Wisconsin. Extensive review of laboratory, physical examination, and imaging reports was performed and data collected for patients with biopsy-proven skin LCH.
  
  
  RESULTS
  Sixteen individuals with skin-limited LCH were identified. The median age at onset of skin eruption was birth (range, birth to 6 mo), and median duration of follow-up was 19.5 months (range, 2 wk to 10 y) from diagnosis. One patient (6%) developed pituitary disease and 1 patient (6%) had refractory skin involvement. All others experienced complete resolution. For patients without progressive or refractory disease, resolution of skin findings occurred within 7 months from onset.
  
  
  CONCLUSIONS
  Progression of skin-limited to multisystem LCH likely may be less frequent than previously described.
authors.affiliation: *Pediatric Hematology and Oncology †Pediatric Dermatology, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Ehrhardt
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Humphrey
authors.forename: Michael E
authors.initials: ME
authors.lastname: Kelly
authors.forename: Yvonne E
authors.initials: YE
authors.lastname: Chiu
authors.forename: Sheila S
authors.initials: SS
authors.lastname: Galbraith
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006646:Histiocytosis, Langerhans-Cell / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D012871:Skin Diseases / Q000473:pathology* / Q000503:physiopathology*