09-03-11

We met with Dr. Ron Hansen, the pediatric dermatologist who originally diagnosed Brandon's LCH in 2005. Back in May, we noticed an odd cluster of freckles in his groin area. I took him to our pediatrician, Dr. Theodorou, in June to show her. She referred us to Dr. Glasser, a pediatric dermatologist in Tucson. She didn't think they were of a concern, but given his history, referred us to Dr. Hansen in Phoenix, so we made the trip. [On a side note, she was familiar with Brandon's history. She was a resident of Dr. Hansen when he was diagnosed back in 2005. She said that pictures of Brandon's lesions were actually presented on a medical exam she had while in program along with his history!]

Dr. Hansen said that Brandon's freckles were not freckles, but "Eruptive moles. They are caused either by the LCH or the chemotherapy. Treatment 'offended' the skin and is causing the break out of moles. It is not LCH or a serious concern. The moles themselves appear normal. However, the pattern/formation and sudden break out is unusual. The seem to be growing up his torso and may continue. They are appearing in an area that had a high proliferation of LCH lesion involvement. This condition has not been seen before in LCH patients, but has occurred in cancer patients treated with chemotherapy." Follow up appointment with Dr. Hansen in six months.

Dr. Hansen also had a few residents on staff. Once they heard that an LCH patient was on campus, we had five of them in our room reviewing our case. They also looked at pictures we had taken of Brandon's lesions.

Left groin area. The picture does not show all of the moles. He has 20 - 30 moles in a 2 x 5 cm. area.

 smaller cluster on his right groin.


We also met with Dr. Wood today. He said that Brandon looks great. We showed him the moles as well. He agreed with Dr. Hansen's diagnosis and is glad that he's following up on it in six months. He also has not seen this before in LCH patients, but said it's not unheard of. Typically, he's seen it in Leukemia patients. He said we may expect the moles to continue to grow, especially in the areas where there was high LCH involvement (head, torso and groin). Some patients get them all over their bodies. In some cases, a biopsy has been taken. They show that the moles have a basal cell carcinoma cell structure, and removal is all that is necessary.

We also spoke to Dr. Wood about Brandon's growth. He is currently in the 10 - 25% for height and 5 - 10% for weight. At this rate, he is expected to be 5'8" as an adult. As long as his growth is within 4 - 6 cm. per year, growth hormone is not necessary. Brandon grew 5 cm. in 2010 and 6 cm. in 2011. Our next check-up is in 6 months. No MRI at this point.