Unrecognized oral manifestations of Langerhans cell histiocytosis which progressed to systemic disease

A 2.5 years old boy was referred to the Department of oral medicine because of substantial erythema and ulcerations on palatal, buccal and alveolar regions. Unfortunately, it took two subsequent visits to our Department in six-months intervals, and re-evaluation at Pediatric oncology clinic where diagnosis of Langerhans cell histiocytosis (LCH) was finally established. At that stage, disease already progressed to multisystem life-threatening presentation, requiring aggressive treatment. Therefore, this case is a reminder of the possibility of occurrence of this rare disease in the oral cavity which might manifest itself in multiple presentations thus easily leading to the misdiagnosis and therefore it could be easily overlooked by dentists.