Clinical examination revealed a solitary, 3.5 × 6.5 cm, non-tender, minimally elevated plaque with central shiny skin and peripheral marginal hyperpigmentation over left elbow.
On scratching the lesion with the blunt end of a pin, the central shiny skin became edematous and itchy (positive Darier's sign).
Presepsin and PCT initial values (T0) did not differ significantly according to the primary sites of infection (urinary tract, lung, abdomen, skin, central venous device-related, central nervous system (CNS) and oral infection) among patients with a confirmed diagnosis of sepsis, severe sepsis or septic shock when the starting focus could be identified (Table 4).
It is known that in Germany and in central Europe, the skin type is different in north and south, with increasing skin darkness in the south.
Macroscopically, shear induced morphology with surface skin, central core and oriented layer between the skin and the core was observed in the cross-section areas of the samples.
The organs and systems involved most frequently were the digestive tract, skin, central nervous system, cardiovascular, endocrine and respiratory systems.
Bone involvement is almost universal in ECD (96%% of cases) [4, 5], and more than 50%% of cases have at least one associated extraskeletal involvement [5], namely the kidney, skin, central nervous system or heart.
Langerhans cell histiocytosis (LCH) represents a spectrum of rare disorders characterised by idiopathic infiltration and accumulation of abnormal histiocytes (i.e. the Langerhans cells) within various tissues (bone marrow, skin, central nervous system, lung, liver, spleen, lymph nodes) causing focal or systemic effects [1].
Extrapulmonary involvement, including lesions of the gastrointestinal tract, genito-urinary tract, cardiovascular system, skin, central nervous system, and eyes, may occur either in association with clinically apparent pulmonary tuberculosis or in isolation, with no clinical or laboratory evidence of pulmonary infection.
