Eosinophilic Granuloma

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EOSINOPHILIC granuloma of bone was first recognized as a clinical entity during the past decade.1,2,3 It is a destructive type of lesion involving usually the interior of the flat bones but occasionally the long bones. Not until a recent publication by Curtis and Cawley4 have cutaneous manifestations been attributed to this condition, nor has the relationship between the osseous and skin lesions been established,5 although such a relationship has been suggested.6

The case which we are reporting is of special interest because of the patient’s age and the manifestation of both osseous and cutaneous lesions.

Case Report

A white baby girl, aged 12 weeks, was first seen at the Cleveland Clinic on March 4 1946. The parents related that ten days previously they had noted that the child was protecting her right arm. On inspection of the shoulder a swelling was noted in the region of the scapula. The past history revealed that at birth delivery had been spontaneous and the weight was 8.5 pounds. Shortly afterward a papular rash was noted in scattered areas over the child’s body. She had gained steadily until the onset of pain in the right shoulder.

On physical examination it was observed that movement of the right shoulder caused some pain. In the infraspinous portion of the scapula a fusiform thickening was palpated, which was smooth, slightly tender, and moved freely with the scapula. Over the chest, back, and buttocks there was a slightly scaly rash (fig. 1). These lesions were dull red in. . .



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