Neoadjuvant intralesional methotrexate for juvenile xanthogranuloma in an adult

Juvenile xanthogranuloma (JXG) is a non-Langerhans cell histiocytosis usually occurring in infants and typically located in the head or neck.1 Clinically, solitary skin lesions are found in 60%–82% of patients and the most common variant is characterized by one yellowish nodule. Adult onset is rare, and although JXG is usually self-limiting in children, spontaneous resolution is uncommon at older ages. In addition, up to 50% of patients with spontaneous regression develop an atrophy or anetodermal area.2 Thus, complete excision is frequently performed in this population subgroup to achieve better cosmetic results. In disseminated forms, different chemotherapy regimens, corticosteroids and other systemic therapies are used. Herein, we report a case of adult JXG treated with intralesional methotrexate (MTX) resulting in a rapid reduction in size