A case of neonatal Langerhans cell histiocytosis initially presenting with haemorrhagic vesicles: a case report and literature review

BACKGROUND: Neonatal Langerhans cell histiocytosis (LCH) presenting with haemorrhagic vesicles as the initial manifestation is exceedingly rare. CASE PRESENTATION: A neonate with generalized hemorrhagic vesicles and partial erosion/crusting at birth, The initial differential diagnosis included infections such as syphilis, toxoplasmosis, rubella, cytomegalovirus, and herpes simplex virus; however, specific antibody testing for these pathogens in both the mother and infant returned negative results. The diagnosis of LCH was confirmed by dermatological consultation and histopathological examination.The infant was treated with intravenous cefotaxime-sulbactam and topical fusidic acid & hirudoid cream, leading to gradual crusting of haemorrhagic vesicles. Follow-up at 3-4 weeks postpartum showed resolution of skin lesions, with no recurrence observed after 2 months. CONCLUSIONS: In this study, we documented a unique and notable manifestation of neonatal Langerhans cell histiocytosis.