This study included 4 patients, 2 males and 2 females. Ages of the studied cases ranged between 3 years and 17 years. Electron microscopy was performed for the studied cases. Widening of the spaces between the intercellular bridges of normal intact keratinocytes and the presence of active Langerhans cells with their characteristic Birbeck granules were the main epidermal findings. In the dermis, Langerhans cells were present in apposition to lymphocytes.