Langerhans cell histiocytosis involving the skin of an elderly woman: a satisfactory remission with oral prednisolone alone.

Langerhans cell histiocytosis (LCH) is a disorder characterized by neoplastic proliferation of Langerhans cells that rarely involves the skin in adults. A 74-year-old woman presented with a fourteen year history of eosinophilic granuloma and bone involvement caused by LCH. She had received three combination therapy courses of curettage and radiation since 1987 and had remained free of LCH signs for seven years, after which she started to notice brown nodules on her left leg. Biopsy specimens taken from the lesions showed massive proliferations of large histiocytic cells. Immunoperoxidase stainings for CD1a and S-100 protein were positive. Electron microscopy identified Birbeck granules in the cytoplasm of the atypical Langerhans cells. Treatment with oral prednisolone alone has resulted in the patient remaining in complete remission for 12 months.

An anatomical study in the oriental nose of the location of the vibrissae-bearing area in relation to the lower lateral cartilage.

BACKGROUND: There is no well-known indicator that can assist with a precise intranasal incision during open rhinoplasty on the caudal border of the lower lateral cartilage. However, the vibrissae-bearing area is clinically known as a good landmark for cartilage. The aim of this study was to investigate the features of the vibrissae-bearing area in relation to the lower lateral cartilage. METHODS: Twenty-four heminoses of fixed Japanese cadavers were dissected to clarify the anatomical location of the vibrissae-bearing area in relation to the lower lateral cartilage. RESULTS: The medial part of the vibrissae-bearing area was precisely located on the medial crus of the lower lateral cartilage. Via a transitional state at the dome, the lateral part was located cephalic to the lateral crus in a manner in which the vibrissae-bearing area was adjacent to the lateral crus (adjacent type) in 22 cases, whilst the vibrissae-bearing area overlapped the lateral crus to some extent (overlap type) in two cases. CONCLUSIONS: The anatomical location of the vibrissae-bearing area in relation to the lower lateral cartilage is almost uniform, suggesting its utility as an open rhinoplasty incision landmark.