Benign cephalic histiocytosis
A one and a half year old girl born of a non-consanguineous marriage presented with multiple asymptomatic raised lesions on both cheeks of 1 year duration. The lesions were slowly increasing in number.\nDermatological examination revealed multiple erythematous to hyperpigmented and skin colored papules limited to both cheeks []. General examination and systemic examination were within normal limits. Physical and mental development were adequate for her age.\nRoutine investigations including serum cholesterol and triglycerides were within normal limits.\nDifferential diagnosis considered were BCH, juvenile xanthogranuloma, and angiofibroma. Skin biopsy from one of the papules showed a normal epidermis and sheets of foamy macrophages, a few histiocytes, and occasional eosinophils in the dermis [Figure and ]. Immunohistochemistry of the biopsy specimen showed CD68 (macrophage marker) positivity and CD 1a (Langerhan's cell marker) negativity [Figures and ]. Correlating the clinical, histopathological, and immunohistochemistry findings, a final diagnosis of BCH was made.