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Juvenile xanthogranuloma — SCE Dermatology MCQ

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HardPaediatric and geneticsJuvenile xanthogranulomaSCE Dermatology

An 18-month-old has twelve yellow-orange papules on the head and trunk. Dermoscopy shows a setting-sun pattern. Which additional assessment is most justified by this presentation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Refer for ophthalmic assessment because multiple early-onset JXG lesions increase ocular risk

Explanation lettering: D = shown as A · A = shown as B · E = shown as C · C = shown as D · B = shown as E

C is correct. The morphology supports juvenile xanthogranuloma. Most solitary cutaneous lesions involute, but very young children with multiple lesions warrant deliberate assessment for ocular involvement, including symptoms and a low threshold for ophthalmology. Multiplicity does not itself prove systemic disease or justify systemic corticosteroid, excision or antimicrobial treatment.

Reference: DermNet: juvenile xanthogranuloma: https://dermnetnz.org/topics/juvenile-xanthogranuloma