Benign Cephalic Histiocytosis

Abstract

To the Editor.— It was with great interest that we read the recent report by Barsky et al 1 of their patient with benign cephalic histiocytosis. In their discussion, they suggested that a patient with atypical juvenile xanthogranuloma (JXG) described by us in 1972 2 might have had benign cephalic histiocytosis rather than JXG. Certainly, the facial lesions of the two patients as depicted in the case reports bear striking resemblance to one another. Three skin biopsy specimens were obtained from our patient and studied extensively by light and electron microscopy. Light microscopy demonstrated findings typi cal of JXG, including a dense dermal infiltrate of histiocytes, foam cells, and scattered eosinophils and lymphocytes. One biopsy specimen contained a moderate number of Touton giant cells. Electron microscopy confirmed the absence of organelles characteristic of histiocytosis X (Birbeck granules) and further showed the lipid-filled macrophages and multinucleated Touton giant cells characteristic of