The skin lesions associated with Langerhans cell histiocytosis are fine erythematous papules surmounted by a scale. They resemble seborrhoeic dermatitis except that they are papular and may be haemorrhagic. The papules are red-brown. They frequently occur on the scalp but may be generalised. They may become confluent forming a greasy scale. Frank ulcers may occur behind the ears and in the groin.
Skin lesions are seen in virtually all patients with Letterer-Siwe disease and in 30 - 50% of those with Hand-Schuller-Christian disease.
Skin manifestations of eosinophilic granulomas are rare, but when they occur, the papules are larger and there may be nodules.
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