Vestnik dermatologii i venerologiiVestnik dermatologii i venerologiiВестник дерматологии и венерологии0042-46092313-6294Rossijskoe Obschestvo Dermatovenerologov i Kosmetologov50510.25208/0042-4609-2019-95-4-57-66CLINICAL CASE REPORTSНАБЛЮДЕНИЕ ИЗ ПРАКТИКИLangerhans cell histiocytosis in an adult patientГистиоцитоз из клеток Лангерганса у взрослой пациенткиKaramovaA. E.КарамоваА. Э.
Russian Federation

Cand. Sci. (Med.), Head of the Dermatology Department,

Korolenko str., 3, bldg 6, Moscow, 107076

к.м.н., заведующая отделом дерматологии,

107076, г. Москва, ул. Короленко, д. 3, стр. 6 

ChikinV. V.ЧикинВ. В.
Russian Federation

Dr. Sci. (Med.), Senior Researcher, Dermatology Department,

Korolenko str., 3, bldg 6, Moscow, 107076

д.м.н., старший научный сотрудник отдела дерматологии,

107076, г. Москва, ул. Короленко, д. 3, стр. 6 

chikin@cnikvi.ruZnamenskayaL. F.ЗнаменскаяЛ. Ф.
Russian Federation

Dr. Sci. (Med.), Leading Researcher, Dermatology Department,

Korolenko str., 3, bldg 6, Moscow, 107076

д.м.н., ведущий научный сотрудник отдела дерматологии,

107076, г. Москва, ул. Короленко, д. 3, стр. 6 

NefedovaM. A.НефедоваМ. А.
Russian Federation

Junior Researcher, Dermatology Department,

Korolenko str., 3, bldg 6, Moscow, 107076

младший научный сотрудник отдела дерматологии,

107076, г. Москва, ул. Короленко, д. 3, стр. 6 

MikhinaV. A.МихинаВ. А.
Russian Federation

Dermatovenerologist, Department of Clinical Dermatology,

Korolenko str., 3, bldg 6, Moscow, 107076

врач-дерматовенеролог отделения клинической дерматологии,

107076, г. Москва, ул. Короленко, д. 3, стр. 6 

BattalovaN. S.БатталоваН. С.
Russian Federation

Resident Physician,

Korolenko str., 3, bldg 6, Moscow, 107076

врач-ординатор,

107076, г. Москва, ул. Короленко, д. 3, стр. 6 

State Research Center of Dermatovenereology and Cosmetology, Ministry of Health of the Russian FederationГосударственный научный центр дерматовенерологии и косметологии Министерства здравоохранения Российской Федерации1908201995457661910201919102019Copyright ©; 2019, Karamova A.E., Chikin V.V., Znamenskaya L.F., Nefedova M.A., Mikhina V.A., Battalova N.S.Copyright ©; 2019, Карамова А.Э., Чикин В.В., Знаменская Л.Ф., Нефедова М.А., Михина В.А., Батталова Н.С.2019Karamova A.E., Chikin V.V., Znamenskaya L.F., Nefedova M.A., Mikhina V.A., Battalova N.S.Карамова А.Э., Чикин В.В., Знаменская Л.Ф., Нефедова М.А., Михина В.А., Батталова Н.С.https://creativecommons.org/licenses/by/4.0https://vestnikdv.ru/jour/article/view/505

Aim: to present a clinical case of a rare dermatosis — Langerhans cell histiocytosis (LCH) in an adult patient.

Materials and methods. A clinical and laboratory examination of a 64-year-old woman who had complained of rashes on the skin of the scalp, neck, trunk and lower extremities accompanied by itching was carried out. A histological study of skin biopsy samples from the lesion area, as well as an immunohistochemical study of Langerhans cell markers — langerin and S-100 protein — were performed.

Results. Clinical manifestations of the disease, the presence of histiocytic infiltrate in the epidermis and dermis during the histological study and immunohistochemical detection of langerin infiltrate cells and S-100 protein were all consistent with the diagnosis of LCH. The therapy with methotrexate subcutaneously significantly improved the patient’s condition.

Conclusion. Verification of the LCH diagnosis requires a histological study of skin biopsy samples and an immunohistochemical study of Langerhans cell markers. The efficacy of methotrexate in the treatment of this disease has been confirmed.

Цель: представление клинического случая редкого дерматоза — гистиоцитоза из клеток Лангерганса у взрослой пациентки.

Материалы и методы. Проведено клинико-лабораторное обследование женщины 64 лет, обратившейся с жалобами на высыпания на коже волосистой части головы, шеи, туловища, нижних конечностей, сопровождавшиеся зудом. Выполнено гистологическое исследование биоптатов кожи из очага поражения и иммуногистохимическое исследование маркеров клеток Лангерганса — лангерина и белка S-100.

Результаты. Клинические проявления заболевания, наличие гистиоцитарного инфильтрата в эпидермисе и дерме при гистологическом исследовании и иммуногистохимическое выявление экспрессии клетками инфильтрата лангерина и белка S-100 соответствовали диагнозу гистиоцитоза из клеток Лангерганса. Терапия метотрексатом подкожно привела к значительному улучшению состояния больной.

Заключение. Для верификации диагноза гистиоцитоза из клеток Лангерганса необходимо проведение гистологического исследования биоптата кожи и иммуногистохимического исследования маркеров клеток Лангерганса. Показана эффективность метотрексата в лечении этого заболевания.

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