HealthCert Blog

Juvenile xanthogranuloma (JXG) is the most common non-Langerhans cell histiocytosis of the skin. It typically presents with solitary or multiple yellowish papules/nodules that tend to self-resolve over time. As JXG often has a sudden appearance and it mimics several melanocytic and non-melanocytic tumours, it is really important to learn how to diagnose it.

For further information on this topic, you may be interested to learn more about the HealthCert Professional Diploma program in General Dermatology.

The classical finding at dermoscopy of JXG has been reported as the “setting-sun appearance”, i.e. a yellow area surrounded by erythema. This is not always found in all the JXG.

We recently performed a retrospective study on 35 children with JXG in order to define the most representative dermoscopic findings.

Incredibly, “setting sun” was just seen in about 1/5 of patients. Symmetry and yellow-orange background were found in most cases (74.3%), vessels surprisingly in more than half of patients (57.1%) and other non-specific dermoscopic findings in a minority of cases.

It is important to underline that the rate of atypical features, such as ulceration or polymorphous vessels, was higher in excised lesions, because they are more typical in other tumours rather than JXG.

In conclusion, dermoscopy may be very helpful in the recognition of JXG, but excision should be planned when it presents with atypical dermoscopic features.

Enjoy reading!

– Dr Vincenzo Piccolo

Full paper:

Di Brizzi EV, Moscarella E, Scharf C, Argenziano G, Piccolo V. Dermoscopy of juvenile xanthogranuloma: a retrospective descriptive study on 35 paediatric patients. J Eur Acad Dermatol Venereol. 2022 Jun 10. doi: 10.1111/jdv.18316. Epub ahead of print.

Watch this research in a video by Dr Vincenzo Piccolo: Dermoscopy of juvenile xanthogranuloma in children

Read more recent research from Dr Vincenzo Piccolo: Cutaneous findings in neurofibromatosis type 1