Infantile perineal protrusion: a statistical, clinical, and histopathologic study.

BACKGROUND: Review of the literature of the peculiar nodule in the perineum of female infants disclosed that the analysis of incidence by gender, observation of the course, histopathologic assessment, and the pathogenesis of the abnormality was suboptimal. OBJECTIVE: We therefore planned to study a large number of children to analyze the incidence by gender, the course, and the pathogenesis of the peculiar perineal nodules. METHODS: Of 500 children (224 boys and 276 girls) who ranged from newborn to 11 years of age, occurrence of the perineal nodules was checked. When nodules were found, the site, shape, size, number, and the onset were examined. Histopathologic examination and observation of the course were carried out in some cases. RESULTS: None of the boys in our population had nodules, but 13% of the girls did. These lesions always occurred as a single peanut-, hen's crest-, or tongue tip-shaped nodule on the perineal midline, and 93% of the lesions had been present since birth. Histologically, the nodule was an outward projection of essentially normal, redundant skin, showing no evidence of lichen sclerosus et atrophicus. CONCLUSION: In view of these findings, we conclude that perineal nodules are a kind of developmental anomaly occurring mostly in girls.

Coexistence of generalized morphea with hisotological changes in lichen sclerosus et atrophicus and lichen planus.

We reported a 44-year-old Japanese woman with generalized multiple sclerotic plaques, which showed histological findings of morphea. This patient also had an erosive lesion on her mouth; its histological findings were consistent with lichen planus. A sclerotic lesion on her thigh showed the histological findings of lichen sclerosus et atrophicus (LSA). These data suggest that similar etiologic events or closely related pathologic processes are involved in morphea, lichen planus, and LSA.

Gastric polyposis caused by multifocal histiocytosis X.

A rare case of gastric polyposis caused by infiltration of Langerhans' cells is reported. A 53 year old Japanese woman complaining of vague abdominal discomfort, was found at endoscopy to have numerous polyps all over the gastric wall. An endoscopic biopsy specimen showed characteristic infiltration of Langerhans' cells in the lamina propria of the mucosa. Functional abnormalities such as impaired gastric acid secretion or malabsorption were not associated with this lesion and the patient was treated conservatively. During follow up over two years, she had a cutaneous eruption with infiltration of histiocytes and osteolytic lesions in the skull. However, no progressive changes occurred in the stomach. This probably benign self-limiting lesion of gastric histiocytosis X may be one of the manifestations of multifocal histiocytosis X, but its aetiology and appropriate treatment have not yet been determined.