Multiple Persistent Nodular Lesions in an Infant: Diagnosing Disseminated Juvenile Xanthogranuloma

We present a 21-month-old female with multiple cutaneous xanthogranulomas (JXG), exhibiting classic “setting sun” pattern which is characterized by an orange-yellow background with an erythematous border. Multiple cutaneous JXG lesions as seen in this patient are rare (4% of patients) and associated with a higher risk of extracutaneous involvement. This case highlights the importance of considering JXG in the differential diagnosis of a generalized persistent eruption in children and the use of dermatoscopy to identify classic pattern findings as a helpful non-invasive diagnostic tool. Since disseminated lesions occur in a minority of patients and carry an increased risk of systemic involvement, particularly ocular complications, referral to ophthalmology and ongoing surveillance is recommended.