{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T23:06:04Z","timestamp":1766012764118,"version":"build-2065373602"},"reference-count":22,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T00:00:00Z","timestamp":1655856000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Clinical Research Award of the First Affiliated Hospital of Xi\u2019an Jiaotong University, China","award":["XJTU1AF-CRF-2019-027","2021ZXY-12","XJYFY-2020N37"],"award-info":[{"award-number":["XJTU1AF-CRF-2019-027","2021ZXY-12","XJYFY-2020N37"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Objectives\u2014To investigate the clinical characteristics, managements, outcome, and evaluate the risk factors of Multisystem (MS) Langerhans Cell Histiocytosis (LCH) with diverse skin lesions as the first sign in four young infants. Methods\u2014Their clinical features, disease progression, therapy, and outcomes were reviewed and analyzed retrospectively. Results\u2014The average onset age of skin lesions was about 2 months. Cases 1 and 2 had risk organs involved (RO+) and a lack of bone lesions, and progression could not be reversed by systemic chemotherapy. They both died eventually. Cases 3 and 4 (RO\u2013) had bone involvement and were given systemic chemotherapy for a prolonged duration. Unluckily, Case 3 had a recurrence 2 years later, while Case 4\u2019s recurrence happened nearly one year later, and diabetes insipidus one and a half years later. They both survived and are still in remission. Conclusion\u2014MS-LCH infants with a low age of the first presentation in the skin are prone to dissemination, while RO+ is associated with high mortality. In addition, bone involvement may be a protective factor. Immunohistochemical examination of skin tissue facilitates correct early diagnosis, and adequate follow-up is necessary.<\/jats:p>","DOI":"10.3390\/jpm12071024","type":"journal-article","created":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T21:31:06Z","timestamp":1655933466000},"page":"1024","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Multisystem Langerhans Cell Histiocytosis in Younger Infants First Presenting in Skin: A Case Series"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4955-099X","authenticated-orcid":false,"given":"Dan","family":"Han","sequence":"first","affiliation":[{"name":"Department of Dermatology, The First Affiliated Hospital of Xi\u2019an Jiaotong University, Xi\u2019an 710061, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2409-9282","authenticated-orcid":false,"given":"Fei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Dermatology, The First Affiliated Hospital of Xi\u2019an Jiaotong University, Xi\u2019an 710061, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wahid H.","family":"Yahya","sequence":"additional","affiliation":[{"name":"Department of Dermatology, The First Affiliated Hospital of Xi\u2019an Jiaotong University, Xi\u2019an 710061, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1691-4352","authenticated-orcid":false,"given":"Rui","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Dermatology, The First Affiliated Hospital of Xi\u2019an Jiaotong University, Xi\u2019an 710061, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9547-270X","authenticated-orcid":false,"given":"Yan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Dermatology, The First Affiliated Hospital of Xi\u2019an Jiaotong University, Xi\u2019an 710061, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6136-1761","authenticated-orcid":false,"given":"Bei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, The First Affiliated Hospital of Xi\u2019an Jiaotong University, Xi\u2019an 710061, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Dermatology, The First Affiliated Hospital of Xi\u2019an Jiaotong University, Xi\u2019an 710061, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5124-0499","authenticated-orcid":false,"given":"Zhuoyu","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Northwest Women and Children\u2019s Hospital, Xi\u2019an 710061, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/j.jaad.2017.05.059","article-title":"Langerhans cell histiocytosis in children: History, classification, pathobiology, clinical manifestations, and prognosis","volume":"78","author":"Krooks","year":"2018","journal-title":"J. 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