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Blanchard M, Morren MA, Busschots AM, Hauben E, Alberti-Violetti S, Berti E, Avallone G, Tavoletti G, Panzone M, Quaglino P, Colonna C, Melchers RC, Vermeer MH, Gniadecki R, Mitteldorf C, Gosmann J, Stadler R, Jonak C, Oren-Shabtai M, Hodak E, Friedland R, Gordon E, Geskin LJ, Scarisbrick JJ, Mayo Martínez F, Noguera Morel L, Pehr K, Amarov B, Faouzi M, Nicolay JP, Kempf W, Blanchard G, Guenova E. Paediatric-onset lymphomatoid papulosis: results of a multicentre retrospective cohort study on behalf of the EORTC Cutaneous Lymphoma Tumours Group (CLTG). Br J Dermatol 2024; 191:233-242. [PMID: 38595050 DOI: 10.1093/bjd/ljae150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/23/2024] [Accepted: 04/09/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Lymphomatoid papulosis (LyP) is a rare cutaneous T-cell lymphoproliferative disorder. Comprehensive data on LyP in the paediatric population are scarce. OBJECTIVES To characterize the epidemiological, clinical, histopathological and prognostic features of paediatric LyP. METHODS This was a retrospective multicentre international cohort study that included 87 children and adolescents with LyP diagnosed between 1998 and 2022. Patients aged ≤ 18 years at disease onset were included. LyP diagnosis was made in each centre, based on clinicopathological correlation. RESULTS Eighty-seven patients from 12 centres were included. Mean age at disease onset was 7.0 years (range 3 months-18 years) with a male to female ratio of 2 : 1. Mean time between the onset of the first cutaneous lesions and diagnosis was 1.3 years (range 0-14). Initial misdiagnosis concerned 26% of patients. LyP was most often misdiagnosed as pityriasis lichenoides et varioliformis acuta, insect bites or mollusca contagiosa. Erythematous papules or papulonodules were the most frequent clinical presentation. Pruritus was specifically mentioned in 21% of patients. The main histological subtype was type A in 55% of cases. When analysed, monoclonal T-cell receptor rearrangement was found in 77% of skin biopsies. The overall survival rate was 100%, with follow-up at 5 years available for 33 patients and at 15 years for 8 patients. Associated haematological malignancy (HM) occurred in 10% of cases (n = 7/73), including four patients with mycosis fungoides, one with primary cutaneous anaplastic large cell lymphoma (ALCL), one with systemic ALCL and one with acute myeloid leukaemia. If we compared incidence rates of cancer with the world population aged 0-19 years from 2001 to 2010, we estimated a significantly higher risk of associated malignancy in general, occurring before the age of 19 years (incidence rate ratio 87.49, 95% confidence interval 86.01-88.99). CONCLUSIONS We report epidemiological data from a large international cohort of children and adolescents with LyP. Overall, the disease prognosis is good, with excellent survival rates for all patients. Owing to an increased risk of associated HM, long-term follow-up should be recommended for patients with LyP.
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Affiliation(s)
- Maël Blanchard
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
- Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
| | - Marie-Anne Morren
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Gabriela Blanchard
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
- Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
| | - Emmanuella Guenova
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
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Alberti-Violetti S, Avallone G, Colonna C, Tavoletti G, Venegoni L, Merlo V, Cambiaghi S, Marzano AV, Berti E, Cavalli R. Paediatric cutaneous lymphomas including rare subtypes: A 40-year experience at a tertiary referral centre. J Eur Acad Dermatol Venereol 2024. [PMID: 38650545 DOI: 10.1111/jdv.20028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 03/08/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Primary cutaneous lymphomas are neoplasms of the immune system with a distinct tropism for the skin and an absence of extracutaneous manifestations at the time of diagnosis. Studies focusing on cutaneous lymphomas in children and adolescents remain scarce and often do not encompass the rare subtypes. OBJECTIVES To address this knowledge gap by describing the clinical, histological and molecular characteristics of a large group of paediatric patients affected by primary cutaneous lymphoma. We also provided the Paediatric Primary Cutaneous Lymphoma Atlas that illustrates the clinicopathological spectrum of observed presentations, in the hope of supporting other physicians in the diagnostic process. METHODS Retrospective chart review of paediatric patients diagnosed with primary cutaneous lymphomas between 1980 and 2022 at the Paediatric Dermatology Unit of Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan. RESULTS A total of 101 patients (58 males, 43 females) met the inclusion criteria. The most common subtypes were lymphomatoid papulosis (n = 48) and mycosis fungoides (n = 31). These were followed by primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorders (n = 7), primary cutaneous anaplastic large-cell lymphomas (n = 5), primary cutaneous marginal zone B-cell lymphomas (n = 3), primary cutaneous follicle centre lymphomas (n = 2), subcutaneous panniculitis-like T-cell lymphomas (n = 2), primary cutaneous peripheral T-cell lymphoma not otherwise specified (n = 1), primary cutaneous precursor B-lymphoblastic lymphoma (n = 1) and Sézary syndrome (n = 1). Clinical follow-up data covering a median of 70.8 months (range 1-324) were available for 74 patients, of whom three died due to cutaneous lymphoma. CONCLUSIONS Our findings shed light on the peculiar aspects and long-term outcomes of paediatric cutaneous lymphomas, particularly emphasizing their distinctive features in comparison to their adult counterparts and exploring the less common subtypes. Further larger-scale studies are warranted to better characterize these entities and to achieve a more rapid and accurate diagnosis.
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Affiliation(s)
- Silvia Alberti-Violetti
- Dermatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Gianluca Avallone
- Dermatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Cristiana Colonna
- Pediatric Dermatology Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca Tavoletti
- Dermatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Luigia Venegoni
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Valentina Merlo
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Stefano Cambiaghi
- Pediatric Dermatology Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelo V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Emilio Berti
- Dermatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Inter-Hospital Pathology Division, IRCCS MultiMedica, Milan, Italy
| | - Riccardo Cavalli
- Pediatric Dermatology Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Khanlari M, Wang W, Liu YC, Wang L, Rubnitz JE, Dixon S, Orr BA, Anelo OM, Cheng Z, Balagopal V, Klco JM. Concurrent peripheral T-cell lymphoma and T-cell lymphoblastic leukemia/lymphoma with identical STIL:: TAL1 fusion events. Haematologica 2024; 109:994-999. [PMID: 37767572 PMCID: PMC10905091 DOI: 10.3324/haematol.2023.283585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Affiliation(s)
- Mahsa Khanlari
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN.
| | - Wei Wang
- Department of Hematopathology, MD Anderson Cancer Center, Houston, TX
| | - Yen-Chun Liu
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Lu Wang
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Jeffrey E Rubnitz
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Stephanie Dixon
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Brent A Orr
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Obianuju M Anelo
- Department of Pathology, University of Tennessee Health Science Center, TN
| | - Zhongshan Cheng
- Center for Applied Bioinformatics, St. Jude Children's Research Hospital, Memphis, TN
| | - Vidya Balagopal
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Jeffery M Klco
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
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Diagnosis and management of cutaneous lymphomas and lymphoid proliferations in children, adolescents and young adults (CAYA). Best Pract Res Clin Haematol 2023; 36:101448. [PMID: 36907638 DOI: 10.1016/j.beha.2023.101448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023]
Abstract
Cutaneous lymphomas and lymphoid proliferations (LPD) in children, adolescents, and young adults (CAYA) are a heterogeneous group of lymphoid neoplasms that present formidable diagnostic challenges to clinicians and pathologists alike. Although rare overall, cutaneous lymphomas/LPD occur in real-world settings and awareness of the differential diagnosis, potential complications, and various therapeutic approaches will help ensure the optimal diagnostic work-up and clinical management. Lymphomas/LPD involving the skin can occur as primary cutaneous disease in a patient that characteristically has lymphoma/LPD confined to the skin, or as secondary involvement in patients with systemic disease. This review will comprehensively summarize both primary cutaneous lymphomas/LPD that occur in the CAYA population as well as those CAYA systemic lymphomas/LPD with propensity for secondary cutaneous involvement. Focus on the most common primary entities occurring in CAYA will include lymphomatoid papulosis, primary cutaneous anaplastic large cell lymphoma, mycosis fungoides, subcutaneous panniculitis-like T-cell lymphoma, and hydroa vacciniforme lymphoproliferative disorder.
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Al Harbi SM, Al Natour S, Al Saif NM, Al Saif N, Al Bayat MI. Primary Cutaneous Follicle Center Lymphoma Presenting as a Solitary Nodule on the Forearm of an Adolescent Girl: A Case Report and Literature Review. Clin Cosmet Investig Dermatol 2023; 16:167-172. [PMID: 36711073 PMCID: PMC9879773 DOI: 10.2147/ccid.s396326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/10/2023] [Indexed: 01/22/2023]
Abstract
Primary cutaneous B-cell lymphomas (PCBCLs) are very rare to be seen in pediatric and adolescent age group, especially primary cutaneous follicle center lymphoma (PCFCL) which is considered the least occurring main subtype. Here, we describe a 16-year-old girl who developed a slowly growing solitary firm smooth surfaced erythematous nodule over her forearm. Histopathological examination showed a dense dermal nodular, periadnexal and perivascular lymphoid infiltrate extending deep to the subcutis. Immunohistochemical staining showed a B-cell population with positivity for CD20, variable staining for BCL6 and CD10 and uniquely staining for BCL2. Although a primary cutaneous marginal zone lymphoma (PCMZL) was considered but the presences of interfollicular BCL6 and CD10 positivity established the diagnosis of PCFCL. To our knowledge, only 12 cases of pediatric and adolescent PCFCL have been described in the literature.
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Affiliation(s)
- Sadan Mohammed Al Harbi
- Department of Dermatology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia,Correspondence: Sadan Mohammed Al Harbi, Department of Dermatology, College of Medicine, Imam Abdulrahman Bin Faisal University, Post Box No. 1982, Dammam, 31441, Saudi Arabia, Email
| | - Sahar Al Natour
- Department of Dermatology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nasser Mohammed Al Saif
- Department of Dermatology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Noura Al Saif
- Department of Dermatology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Methal Isam Al Bayat
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Gomes N, Nogueira A, Silva R, Azevedo F. Multiple painless papulonodules in a 3-year-old girl: type A lymphomatoid papulosis. An Bras Dermatol 2022; 97:689-690. [PMID: 35842335 PMCID: PMC9453476 DOI: 10.1016/j.abd.2020.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/10/2020] [Accepted: 11/08/2020] [Indexed: 11/28/2022] Open
Affiliation(s)
- Nuno Gomes
- Department of Dermatovenereology of Centro Hospitalar, Universitário de São João EPE, Porto, Portugal.
| | - Ana Nogueira
- Department of Dermatovenereology of Centro Hospitalar, Universitário de São João EPE, Porto, Portugal
| | - Roberto Silva
- Department of Pathology of Centro Hospitalar, Universitário de São João EPE, Porto, Portugal
| | - Filomena Azevedo
- Department of Dermatovenereology of Centro Hospitalar, Universitário de São João EPE, Porto, Portugal
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Shi R, Koh MJA. Two Histologic Patterns of Lymphomatoid Papulosis Occurring in a Child: A Matter of Timing? J Pediatr Hematol Oncol 2022; 44:e775-e778. [PMID: 34862355 DOI: 10.1097/mph.0000000000002356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/17/2021] [Indexed: 11/25/2022]
Abstract
There are several histologic patterns seen in lymphomatoid papulosis, with the possibility of different subtypes occurring in the same patient. We report a case of lymphomatoid papulosis presenting with 2 histologic subtypes (types A and B) occurring concomitantly in a 10-year-old child, and postulate that the different subtypes occur dependent on the age of the lesion biopsied. Incidentally, one of the biopsies also shows a rarely seen pattern of pseudoepitheliomatous hyperplasia in a pediatric lymphomatoid papulosis patient.
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Affiliation(s)
- Ruoyu Shi
- Department of Pathology and Laboratory Medicine
| | - Mark Jean-Aan Koh
- Dermatology Service, KK Women's & Children's Hospital, Singapore, Singapore
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Colmant C, Demers MA, Hatami A, Coulombe J, McCuaig CC, Piram M, Marcoux D, Kokta V, Powell J. Pediatric Cutaneous Hematologic Disorders: Cutaneous Lymphoma and Leukemia Cutis: Experience of a Tertiary-Care Pediatric Institution and Review of the Literature. J Cutan Med Surg 2022; 26:349-360. [PMID: 35167768 DOI: 10.1177/12034754221077694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cutaneous hematologic malignancies are rare in children, and the literature about them is still sparse. OBJECTIVE The purpose of our study was to report our experience with pediatric cases of cutaneous hematologic disorders and describe their clinical and histological features. METHODS Data were retrospectively collected from the histopathologic database of the CHU Sainte-Justine, University of Montreal, Montreal, Canada. All patients up to 18 years of age with a diagnosis of a primary cutaneous lymphoma (including lymphomatoid papulosis), secondary cutaneous lymphoma or cutaneous manifestations of leukemia, followed from 1980 to 2019 at our center were reviewed. RESULTS Thirty-six patients were included. Age at presentation ranged from birth to 18 years of age (mean 7.83 ± 5.16; median 7.0). Ten different hematologic disorders were identified according to the WHO-EORTC classifications: lymphomatoid papulosis (10 cases), mycosis fungoides (6 cases), anaplastic large cell lymphoma (4 cases), pre-B acute lymphoid leukemia (5 cases), primary cutaneous marginal zone B-cell lymphoma (4 cases), primary cutaneous CD4+medium T-cell lymphoproliferative disorder (1 case), extranodal NK/T-cell lymphoma (1 case), hydroa vacciniforme-like lymphoproliferative disorder (1 case), B-cell lymphoblastic lymphoma (1 case) and acute myeloid leukemia (3 cases). CONCLUSION The most common subtype of cutaneous hematologic disease in our single institution study was lymphomatoid papulosis (type A and type C), followed by mycosis fungoides. Recognition of this large clinical and histological spectrum by dermatologists is important because diagnosis is often established by biopsy of skin lesions, even in secondary cutaneous cases. Moreover, the clinicopathological correlation is of utmost importance for the final diagnosis of those pathologies.
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Affiliation(s)
- Caroline Colmant
- Division of Pediatric Dermatology, Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Quebec, Canada
| | - Marc-André Demers
- Division of Pediatric Dermatology, Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Quebec, Canada
| | - Afshin Hatami
- Division of Pediatric Dermatology, Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Quebec, Canada
| | - Jerome Coulombe
- Division of Pediatric Dermatology, Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Quebec, Canada
| | - Catherine Cameron McCuaig
- Division of Pediatric Dermatology, Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Quebec, Canada
| | - Maryam Piram
- Division of Pediatric Dermatology, Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Quebec, Canada
| | - Danielle Marcoux
- Division of Pediatric Dermatology, Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Quebec, Canada
| | - Victor Kokta
- Department of Pathology, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Quebec, Canada
| | - Julie Powell
- Department of Pathology, Sainte-Justine University Hospital Center, University of Montreal, Montreal, Quebec, Canada
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Matsuzawa T, Shu J, Nakamura Y, Hino M, Ikeda JI, Sugaya M, Matsue H. Anaplastic large-cell lymphoma presenting as large ulcerated tumors and small papules in a 15-year-old girl. DERMATOL SIN 2022. [DOI: 10.4103/ds.ds_5_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lebas E, Collins P, Somja J, Nikkels AF. A Comprehensive Update of the Atypical, Rare and Mimicking Presentations of Mycosis Fungoides. Dermatol Ther (Heidelb) 2021; 11:1931-1951. [PMID: 34709600 PMCID: PMC8611162 DOI: 10.1007/s13555-021-00625-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction Mycosis fungoides (MF) is the most frequent subtype of primary cutaneous T cell lymphomas (pCTCL). The diagnosis may be particularly difficult in the early stages as well as in atypical and rare clinical presentations. Furthermore, MF may simulate a large variety of common dermatologic disorders and patterns, both histopathologically and clinically. Methods A literature search was performed to provide a comprehensive update on the rare and atypical MF manifestations as well as the dermatoses and dermatological patterns that could be imitated by MF. Results A total of 114 publications were found describing a series of different dermatoses and dermatological patterns mimicked by MF, as well as some particular localizations of MF lesions and dermatoses that occur in preexisting MF lesions. Conclusions The number of dermatoses that can be imitated by MF is ever-increasing. Patients with common dermatologic conditions that prove to be treatment refractory should be biopsied without delay, and sequentially as necessary, to prevent delay in diagnosis and progression of disease. Clinicopathologic correlation is the best way of diagnosis.
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Affiliation(s)
- Eve Lebas
- Department of Dermatology, CHU du Sart Tilman, University of Liège, 4000, Liège, Belgium
| | - Patrick Collins
- Department of Dermatopathology, CHU du Sart Tilman, University of Liège, 4000, Liège, Belgium
| | - Joan Somja
- Department of Dermatopathology, CHU du Sart Tilman, University of Liège, 4000, Liège, Belgium
| | - Arjen F Nikkels
- Department of Dermatology, CHU du Sart Tilman, University of Liège, 4000, Liège, Belgium.
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Wohlmuth-Wieser I. Primary cutaneous T-cell lymphomas in childhood and adolescence. J Dtsch Dermatol Ges 2021; 19:563-581. [PMID: 33861015 DOI: 10.1111/ddg.14509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/09/2021] [Indexed: 12/12/2022]
Abstract
Primary cutaneous lymphomas are extranodal non-Hodgkin lymphomas of T- or B- cell origin, that predominantly affect older patients but have been reported in all age groups and as early as in the first years of life. Diagnosis of cutaneous lymphomas is challenging and requires high clinical suspicion and close collaboration between dermatologists, pediatric oncologists and pathologists. Skin involvement of non-Hodgkin lymphomas in children or adolescents can either be primary cutaneous or secondary due to an underlying nodal lymphoma. The most common primary cutaneous lymphomas encountered in children are of T-cell origin, with mycosis fungoides being the most prevalent cutaneous T-cell lymphoma, followed by CD30+ lymphoproliferative disorders. While cutaneous lymphomas share clinicopathologic characteristics between juvenile and adult forms, there are important differences in terms of clinical presentation, diagnosis and treatment. The hypopigmented variant of mycosis fungoides seems to be overrepresented in the pediatric age group. Prognosis and treatment of mycosis fungoides are stage dependent. The majority of children present with early-stage disease and respond well to topical corticosteroids and phototherapy.
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Affiliation(s)
- Iris Wohlmuth-Wieser
- Department of Dermatology and Allergology, Paracelsus Medical University Salzburg, Salzburg, Austria
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Bomze D, Sprecher E, Goldberg I, Samuelov L, Geller S. Primary Cutaneous B-Cell Lymphomas in Children and Adolescents: A SEER Population-Based Study. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2021; 21:e1000-e1005. [PMID: 34417159 DOI: 10.1016/j.clml.2021.07.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/19/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Although primary cutaneous B-cell lymphomas (PCBCL) comprise 25% of all cutaneous lymphomas, their incidence in the pediatric population is unknown, and the information on pediatric PCBCL has mostly been gathered from individual case reports or series from single centers. PATIENTS AND METHODS This was a population-based, retrospective cohort study of patients in 18 cancer registries in the United States diagnosed between 2000 to 2016 through the Surveillance, Epidemiology, and End Results (SEER) program. Age-adjusted incidence rates were calculated for PCBCL in pediatric (<20 years) and adult (≥20 years) populations. Demographic, clinical, and pathological characteristics of PCBCL were compared between the two groups. RESULTS A total of 48 pediatric and 5128 adult PCBCL cases were included. Median age at diagnosis was 16.5 years and 65 years in the two groups, respectively. The major histologic subtypes of pediatric cases were marginal zone lymphoma (77.1%), followed by diffuse large B-cell lymphoma (12.5%) and follicle center lymphoma (10.4%), which were equally distributed in adults. The age-adjusted pediatric PCBCL incidence rate (per 1,000,000 person-years) was 0.12 (95% CI 0.09-0.16). The incidence in the adult population was approximately 40-fold higher than the one observed in the pediatric group (IRR 41.4, 95% CI 31.2-56.2). All 48 pediatric cases were alive during a median follow-up time of 48 months. CONCLUSIONS Pediatric PCBCL is a very rare disease affecting mostly adolescents of both sexes. The major histologic subtype is marginal zone lymphoma, and the prognosis is favorable.
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Affiliation(s)
- David Bomze
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eli Sprecher
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilan Goldberg
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liat Samuelov
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shamir Geller
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Clinical characteristics and long-term outcome of 223 patients with mycosis fungoides at a single tertiary center in Korea: A 29-year review. J Am Acad Dermatol 2021; 86:1275-1284. [PMID: 34197872 DOI: 10.1016/j.jaad.2021.06.860] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 06/16/2021] [Accepted: 06/20/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Data regarding Asian patients with mycosis fungoides (MF) are limited. OBJECTIVE We aimed to investigate the clinical profile and long-term outcomes of patients with MF in Korea. METHODS A retrospective review of 223 patients with MF who were followed up for more than 6 months or died of MF within 6 months of diagnosis was performed. RESULTS Approximately 96.4% and 3.6% of the patients had an early stage and advanced stage, respectively. The mean age at diagnosis was 44.8 years. The mean duration of symptoms before diagnosis was 47.0 months. Various subtypes were noted, including mycosis fungoides palmaris et plantaris (21.5%), folliculotropic (8.5%), pityriasis lichenoides-like (6.7%), ichthyosiform (4.0%), lichenoid purpura-like (2.7%), and hypopigmented (2.2%) MF. Juvenile patients accounted for 16.6%. The higher the skin T stage, the poorer the response to treatment. The 10-year overall survival was 96.8% in early-stage patients and 25.0% in advanced-stage patients. General prognosis was favorable, while recurrence and subtype switching were seen in 29.4% and 2.7% of patients, respectively. LIMITATIONS Our patients may not represent all Korean patients with MF. CONCLUSION MF in Korea has a high proportion of variants, a younger age at onset, and favorable prognosis. A high index of suspicion and skin biopsy are needed for early diagnosis.
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Edmonds N, Hernández-Pérez M, Holsinger M, Gru AA. Primary cutaneous follicle center lymphoma in a 16-year-old girl. J Cutan Pathol 2021; 48:663-668. [PMID: 33326136 DOI: 10.1111/cup.13939] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/05/2020] [Accepted: 12/12/2020] [Indexed: 12/01/2022]
Abstract
In the pediatric and adolescent age group, primary cutaneous lymphomas are rare, especially cutaneous B-cell lymphomas. According to the World Health Organization, the three main subtypes of primary cutaneous B-cell lymphomas are primary cutaneous marginal zone B-cell lymphoma (PCMZL), primary cutaneous follicle center lymphoma (PCFCL), and primary cutaneous diffuse large B-cell lymphoma, leg type. We present an extraordinary case of PCFCL arising in a 16-year-old female, only the sixth case of PCFCL to be reported in the literature in a patient less than 20 years old. Although PCMZL was considered in this case, the finding of lambda light chain restriction in the BCL-6 and CD10 positive population of lymphocytes established the diagnosis of primary cutaneous follicle center lymphoma. Not many data currently exist on the prognosis of PCFCL in young individuals, but adult PCFCL has a good prognosis with an indolent course and 5-year survival rates over 95%. Because of its uncommon manifestation in young patients, the diagnosis of PCFCL is often delayed or missed. This case is presented to raise awareness of PCFCL in the pediatric/ adolescent population and to contribute to the ongoing research of this condition.
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Affiliation(s)
- Nicole Edmonds
- Department of Pathology, University of Virginia, Charlottesville, Virginia, USA
| | | | | | - Alejandro A Gru
- Department of Pathology, University of Virginia, Charlottesville, Virginia, USA
- Department of Dermatology, University of Virginia, Charlottesville, Virginia, USA
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15
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Wohlmuth-Wieser I. Primär kutane T‐Zell‐Lymphome im Kindes‐ und Jugendalter. J Dtsch Dermatol Ges 2021; 19:563-583. [PMID: 33861014 DOI: 10.1111/ddg.14509_g] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/09/2021] [Indexed: 12/18/2022]
Abstract
Primär kutane Lymphome sind extranodale T- oder B-Zell-Non-Hodgkin-Lymphome, die vorwiegend ältere Patienten betreffen, aber in allen Altersgruppen einschließlich der ersten Lebensjahre auftreten können. Die Diagnose kutaner Lymphome ist eine Herausforderung und erfordert einen hohen klinischen Verdacht sowie enge Zusammenarbeit zwischen Dermatologen, pädiatrischen Onkologen und Pathologen. Generell müssen primär kutane Lymphome von sekundär kutanen Lymphomen, welche meist von nodalen oder extranodalen Lymphomen ausgehen, unterschieden werden. Die häufigsten primär kutanen Lymphome im Kindesalter sind T-Zell Lymphome, wobei Mycosis fungoides das häufigste kutane T-Zell-Lymphom darstellt, gefolgt von CD30+ lymphoproliferativen Erkrankungen. Während klinisch-pathologische Merkmale kutaner Lymphome bei Jugendlichen und Erwachsenen ähnlich sind, gibt es wichtige Unterschiede bezüglich klinischer Präsentation, Diagnose und Behandlung. Die hypopigmentierte Variante der Mycosis fungoides scheint in der pädiatrischen Altersgruppe überrepräsentiert zu sein. Prognose und Behandlung der Mycosis fungoides sind stadienabhängig. Die Mehrheit der Kinder weist ein frühes Krankheitsstadium auf und spricht gut auf topische Kortikosteroide und Phototherapie an.
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Affiliation(s)
- Iris Wohlmuth-Wieser
- Klinik für Dermatologie und Allergologie, Paracelsus Medizinische Privatuniversität Salzburg, Österreich
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Scheu A, Schnabl SM, Steiner DP, Fend F, Berneburg M, Yazdi AS. Stellenwert diagnostischer Verfahren und Risiko von Zweittumoren bei primär kutanen Lymphomen. J Dtsch Dermatol Ges 2021; 19:373-382. [PMID: 33709586 DOI: 10.1111/ddg.14400_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 08/14/2020] [Indexed: 11/30/2022]
Abstract
HINTERGRUND Primär kutane Lymphome (PCL) unterscheiden sich oft stark im klinischen Verhalten und in der Prognose von systemischen Lymphomen des gleichen histopathologischen Typs. Ziel der Studie war es, die Verteilung der PCL-Subtypen, die Zeitspanne von der Krankheitsmanifestation bis zur Diagnosestellung, den Stellenwert diagnostischer Verfahren, das Auftreten von Zweittumoren und die verschiedenen Behandlungsmodalitäten im Rahmen des Krankheitsverlaufs zu untersuchen. PATIENTEN UND METHODIK Retrospektive Analyse von 152 Patienten mit PCL, die von 2010-2012 an der Universitäts-Hautklinik Tübingen behandelt wurden. ERGEBNISSE 105 Patienten mit primär kutanem T-Zell-Lymphom (CTCL) (69,1 %) und 47 Patienten mit primär kutanem B-Zell-Lymphom (CBCL) (30,9 %) wurden eingeschlossen. Die Zeitspanne von der Krankheitsmanifestation bis zur Diagnose betrug durchschnittlich vier Jahre. Mycosis fungoides (MF) (47,4 %) wurde am häufigsten diagnostiziert. Die First-Line-Therapien umfassten hier entweder eine alleinige Phototherapie (PUVA, n = 48; UVB 311 nm, n = 7) oder Kombinationstherapien (PUVA mit systemischen Retinoiden, n = 18). Häufigste Second-Line-Therapie war Interferon (INF)-α plus PUVA (n = 15). Der Behandlungsverlauf war insgesamt günstig (45,2 % Remission, 28,6 % stabile Erkrankung, 22,6 % Progress). Maligne Komorbiditäten wurden im Vergleich zu einer gesunden Vergleichsgruppe häufiger beobachtet. SCHLUSSFOLGERUNGEN Bis zur Diagnosestellung der PCL dauert es oft mehrere Jahre. Der Wert der Staging-Verfahren ist gering. Die Behandlungsmodalitäten in früheren MF-Stadien basieren hauptsächlich auf der Phototherapie.
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Affiliation(s)
- Alexander Scheu
- Universitäts-Hautklinik Tübingen, Eberhard Karls Universität Tübingen
| | | | | | - Falko Fend
- Institut für Pathologie und Neuropathologie, Eberhard Karls Universität Tübingen
| | - Mark Berneburg
- Universitäts-Hautklinik Tübingen, Eberhard Karls Universität Tübingen.,Klinik und Poliklinik für Dermatologie, Universität Regensburg
| | - Amir Sadegh Yazdi
- Universitäts-Hautklinik Tübingen, Eberhard Karls Universität Tübingen.,Klinik für Dermatologie und Allergologie, Uniklinik RWTH Aachen
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17
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Scheu A, Schnabl SM, Steiner DP, Fend F, Berneburg M, Yazdi AS. Importance of diagnostics and risk of secondary malignancies in primary cutaneous lymphomas. J Dtsch Dermatol Ges 2021; 19:373-381. [PMID: 33576187 DOI: 10.1111/ddg.14400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 08/14/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Primary cutaneous lymphomas (PCL) often strongly differ in clinical behavior and prognosis from systemic lymphomas of the same histopathologic type. The aim of the study was to investigate the distribution of PCL subtypes, the average time from disease manifestation to diagnosis, the importance of diagnostic procedures, the occurrence of secondary malignancies and the different treatment modalities. PATIENTS AND METHODS Retrospective analysis of 152 patients with PCL examined at the Department of Dermatology of the University Hospital Tübingen from 2010-2012. RESULTS 105 patients with CTCL (69.1 %) and 47 patients with CBCL (30.9 %) were included. The average time from disease manifestation to diagnosis was four years. The most common diagnosed lymphoma was mycosis fungoides (MF) (47.4 %). First-line therapies here include phototherapy only (psoralen-UV-A [PUVA], n = 48; UVB 311 nm, n = 7) or combination therapies primarily phototherapy with systemic retinoids (n = 18). Most frequent second-line therapy was interferon (INF)-α plus PUVA (n = 15). The outcome was favorable (45.2 % remission, 28.6 % stable disease, 22.6 % progressive disease). Malignant comorbidities were observed more frequently compared to a healthy control group. CONCLUSIONS The diagnosis of lymphoma often takes several years. The value of staging procedures is still low and the treatment modalities for MF in earlier stages are mainly based on phototherapy.
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Affiliation(s)
- Alexander Scheu
- Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | | | | | - Falko Fend
- Institute of Pathology and Neuropathology, Eberhard Karls University, Tuebingen, Germany
| | - Mark Berneburg
- Department of Dermatology, Eberhard Karls University, Tuebingen, Germany.,Clinic and Polyclinic for Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Amir Sadegh Yazdi
- Department of Dermatology, Eberhard Karls University, Tuebingen, Germany.,Department of Dermatology and Allergology, University Hospital RWTH Aachen, Aachen, Germany
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18
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Singer TG, Bray MA, Chan A, Ikeda S, Walters B, Fuller MY, Falco C. Chronic Ulcers and Malnutrition in an African Patient. Pediatrics 2020; 146:e20201717. [PMID: 33115794 PMCID: PMC8061712 DOI: 10.1542/peds.2020-1717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2020] [Indexed: 11/24/2022] Open
Abstract
An 11-year-old girl with a congenitally malformed left hand, sickle cell trait, asthma, and history of appendicitis was transferred from Zambia for evaluation and treatment of widespread suppurative and ulcerative skin lesions that typically appeared after trauma to her skin. The ulcers first presented 3 years earlier but had markedly worsened in the 9 months before transfer, spreading circumferentially on her extremities and abdomen at the site of an appendectomy. They were painful and did not resolve with multiple courses of intravenous antibiotics and close management by a pediatric infectious disease specialist working for a nongovernmental organization (NGO) in her home country. Per NGO records, she had previously been average weight-for-age. On presentation after international transfer, she was severely malnourished, with lesions covering ∼35% of her body. In initial workup, leukocytosis of 21 × 103 cells per μL (79% neutrophils), hemoglobin of 6.1 g/dL, and mean corpuscular volume of 66 fL were found. Iron studies revealed an iron level of 18 μg/dL, ferritin level of 55 ng/mL, total iron binding capacity of 222 μg/dL, and transferrin saturation of 8%. Inflammatory markers were elevated, C-reactive protein was 20.1 mg/dL, and the erythrocyte sedimentation rate was 131 mm/h. A chest computed tomography scan revealed bilateral pulmonary nodules, the largest in her left upper lobe measuring 2.4 × 2.0 × 1.9 cm. Our panel of experts reviews the evaluation and treatment of this patient with extensive suppurative and ulcerative skin lesions and the factors considered in offering charity care to international patients.
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Affiliation(s)
| | | | | | | | - Brittany Walters
- International and Destination Medicine, Texas Children's Hospital, Houston, Texas
| | - Maren Y Fuller
- Pathology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas; and
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19
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Gibson SE, Swerdlow SH. How I Diagnose Primary Cutaneous Marginal Zone Lymphoma. Am J Clin Pathol 2020; 154:428-449. [PMID: 32808967 DOI: 10.1093/ajcp/aqaa116] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Primary cutaneous marginal zone lymphoma (PCMZL) is 1 of the 3 major subtypes of primary cutaneous B-cell lymphoma. The diagnosis of PCMZL may be challenging, as the differential diagnosis includes benign cutaneous lymphoproliferations as well as other primary or secondary cutaneous B-cell or T-cell lymphomas. This review describes our approach to the diagnosis of PCMZL. METHODS Two cases are presented that illustrate how we diagnose each of the 2 subtypes of PCMZL. The clinicopathologic features of PCMZL and the ways in which these cases can be distinguished from both benign and other neoplastic entities are emphasized. RESULTS A definitive diagnosis of PCMZL requires the incorporation of histologic and immunophenotypic features, molecular genetic studies in some cases, and just as importantly, clinical findings. Emerging data suggest that the heavy chain class-switched cases may be more like a clonal chronic lymphoproliferative disorder. CONCLUSIONS The 2 subtypes of PCMZL create different diagnostic challenges and require the use of a multiparameter approach. Although very indolent, it is important to distinguish PCMZLs from reactive proliferations, because they frequently recur and may require antineoplastic therapies. It is also critical to distinguish PCMZLs from other B- or T-cell lymphomas so that patients are properly evaluated and not overtreated.
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20
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Park MY, Hwang S, Kim J, Almurayshid AI, Yoon SO, Oh SH. Rare case of CD8+ CD56+ cytotoxic variant of mycosis fungoides clinically presenting with a combination of hypopigmentation and poikiloderma. Int J Dermatol 2020; 59:e374-e376. [PMID: 32627839 DOI: 10.1111/ijd.15045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/31/2020] [Accepted: 06/10/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Min-Young Park
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Shinwon Hwang
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jemin Kim
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Abdurrahman I Almurayshid
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.,Department of Dermatology, College of Medicine, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Sun Och Yoon
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Ho Oh
- Department of Dermatology, Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
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21
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Reddy V, Thibodeaux Q, Bhutani T, Sugarman JL. Lymphomatoid papulosis successfully managed with excimer laser maintenance therapy. JAAD Case Rep 2020; 6:495-497. [PMID: 32490107 PMCID: PMC7256238 DOI: 10.1016/j.jdcr.2020.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Vidhatha Reddy
- Correspondence to: Vidhatha Reddy, BA, 515 Spruce Street, San Francisco, CA 94118.
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22
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Gru AA, McHargue C, Salavaggione AL. A Systematic Approach to the Cutaneous Lymphoid Infiltrates: A Clinical, Morphologic, and Immunophenotypic Evaluation. Arch Pathol Lab Med 2020; 143:958-979. [PMID: 31339758 DOI: 10.5858/arpa.2018-0294-ra] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— The evaluation of cutaneous lymphoid infiltrates, both neoplastic and inflammatory, occurs very frequently in routine dermatopathologic examination and consultation practices. The "tough" cutaneous lymphoid infiltrate is feared by many pathologists; skin biopsies are relatively small, whereas diagnostic possibilities are relatively broad. It is true that cutaneous lymphomas can be difficult to diagnose and that in many circumstances multiple biopsies are required to establish a correct diagnostic interpretation. As a reminder, one should understand that low-grade cutaneous lymphomas are indolent disorders that usually linger for decades and that therapy does not result in disease cure. It is also important to remember that in most circumstances, those patients will die from another process that is completely unrelated to a diagnosis of skin lymphoma (even in the absence of specific therapy). OBJECTIVE.— To use a clinicopathologic, immunophenotypic, and molecular approach in the evaluation of common lymphocytic infiltrates. DATA SOURCES.— An in-depth analysis of updated literature in the field of cutaneous lymphomas was done, with particular emphasis on updated terminology from the most recent World Health Organization classification of skin and hematologic tumors. CONCLUSIONS.— A diagnosis of cutaneous lymphoid infiltrates can be adequately approached using a systematic scheme following the proposed ABCDE system. Overall, cutaneous T- and B-cell lymphomas are rare and "reactive" infiltrates are more common. Evaluation of lymphoid proliferations should start with a good sense of knowledge of the clinical presentation of the lesions, the clinical differential considerations, and a conscientious and appropriate use of immunohistochemistry and molecular tools.
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Affiliation(s)
- Alejandro A Gru
- From the Departments of Pathology (Drs Gru and Salavaggione) and Dermatology (Dr Gru), University of Virginia, Charlottesville; and the Department of Dermatology (Dr McHargue), Henry Ford Health System, Detroit, Michigan
| | - Chauncey McHargue
- From the Departments of Pathology (Drs Gru and Salavaggione) and Dermatology (Dr Gru), University of Virginia, Charlottesville; and the Department of Dermatology (Dr McHargue), Henry Ford Health System, Detroit, Michigan
| | - Andrea L Salavaggione
- From the Departments of Pathology (Drs Gru and Salavaggione) and Dermatology (Dr Gru), University of Virginia, Charlottesville; and the Department of Dermatology (Dr McHargue), Henry Ford Health System, Detroit, Michigan
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23
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24
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Valencia Ocampo O, Julio L, Zapata V, Correa L, Vasco C, Correa S, Velásquez-Lopera M. Micosis fungoide en niños y adolescentes: descripción de una serie de 23 casos. ACTAS DERMO-SIFILIOGRAFICAS 2020; 111:149-156. [DOI: 10.1016/j.ad.2019.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 10/26/2022] Open
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25
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Sidiropoulou P, Nikolaou V, Marinos L, Voudouri D, Komini E, Economidi A, Rigopoulos D, Stratigos A. The different faces of mycosis fungoides: results of a single‐center study. Int J Dermatol 2019; 59:314-320. [DOI: 10.1111/ijd.14735] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 10/21/2019] [Accepted: 11/05/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Polytimi Sidiropoulou
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens Cutaneous Lymphoma Clinic, “A. Sygros” Hospital for Skin & Venereal Diseases Athens Greece
| | - Vasiliki Nikolaou
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens Cutaneous Lymphoma Clinic, “A. Sygros” Hospital for Skin & Venereal Diseases Athens Greece
| | - Leonidas Marinos
- Hematopathology Department “Evangelismos” General Hospital Athens Greece
| | - Dimitra Voudouri
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens Cutaneous Lymphoma Clinic, “A. Sygros” Hospital for Skin & Venereal Diseases Athens Greece
| | - Elena Komini
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens Cutaneous Lymphoma Clinic, “A. Sygros” Hospital for Skin & Venereal Diseases Athens Greece
| | - Afroditi Economidi
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens Cutaneous Lymphoma Clinic, “A. Sygros” Hospital for Skin & Venereal Diseases Athens Greece
| | - Dimitris Rigopoulos
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens Cutaneous Lymphoma Clinic, “A. Sygros” Hospital for Skin & Venereal Diseases Athens Greece
| | - Alexander Stratigos
- 1st Department of Dermatology‐Venereology Faculty of Medicine National and Kapodistrian University of Athens Cutaneous Lymphoma Clinic, “A. Sygros” Hospital for Skin & Venereal Diseases Athens Greece
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Photo-photochemotherapy in Juvenile-onset Mycosis Fungoides: A Retrospective Study on 9 Patients. J Pediatr Hematol Oncol 2019; 41:34-37. [PMID: 30130275 DOI: 10.1097/mph.0000000000001277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Mycosis fungoides (MF) is a rare disease and is considered the most common form of cutaneous T-cell lymphoma. Given the infrequent incidence of MF in patients under the age of 20, there are no established guidelines for the treatment of these patients; the overwhelming majority have an early-stage disease and progression to more advanced stages is very rare. This study presents the safety and effectiveness of photo-photochemotherapy as a first-line approach in the treatment of an early-stage MF even in young patients.
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27
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Rovaris M, Colato C, Girolomoni G. Pediatric CD8+/CD56+ mycosis fungoides with cytotoxic marker expression: A variant with indolent course. J Cutan Pathol 2018; 45:782-785. [DOI: 10.1111/cup.13317] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 06/14/2018] [Accepted: 06/28/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Marco Rovaris
- Department of Medicine, Section of Dermatology and Venereology; University of Verona; Verona Italy
| | - Chiara Colato
- Department of Pathology and Diagnostics, Section of Pathology; University of Verona; Verona Italy
| | - Giampiero Girolomoni
- Department of Medicine, Section of Dermatology and Venereology; University of Verona; Verona Italy
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28
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Mitteldorf C, Stadler R, Sander CA, Kempf W. Folliculotropic mycosis fungoides. J Dtsch Dermatol Ges 2018; 16:543-557. [DOI: 10.1111/ddg.13514] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/28/2017] [Indexed: 01/02/2023]
Affiliation(s)
- Christina Mitteldorf
- Department of DermatologyVenereology and AllergologyHELIOS Medical Center Hildesheim Hildesheim Germany
- Department of DermatologyVenereology and AllergologyGöttingen University Medical Center Göttingen Germany
| | - Rudolf Stadler
- Department of DermatologyVenereologyAllergologyand PhlebologyMühlenkreisklinikenJohannes Wesling Medical Center Minden Germany
| | - Christian A. Sander
- Eduard Arning Department of Dermatology and AllergologyAsklepios Klinik St. Georg Hamburg Germany
| | - Werner Kempf
- Kempf und PfaltzDermatopathology Laboratory Zurich Switzerland
- Department of DermatologyVenereology and AllergologyZurich University Hospital Zurich Switzerland
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29
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Mitteldorf C, Stadler R, Sander CA, Kempf W. Die follikulotrope Mycosis fungoides. J Dtsch Dermatol Ges 2018; 16:544-559. [DOI: 10.1111/ddg.13514_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/28/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Christina Mitteldorf
- Klinik für DermatologieVenerologie und AllergologieHELIOS Klinikum Hildesheim
- Klinik für DermatologieVenerologie und Allergologie Göttingen
| | - Rudolf Stadler
- Universitätsklinik für DermatologieVenerologieAllergologie und PhlebologieMühlenkreisklinikenJohannes Wesling Klinikum Minden
| | - Christian A. Sander
- Eduard‐Arning‐Klinik für Dermatologie und AllergologieAsklepios Klinik St. Georg Hamburg
| | - Werner Kempf
- Kempf und Pfaltz histologische Diagnostik Zürich
- Universitätsspital ZürichKlinik für DermatologieVenerologie und Allergologie Zürich
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Abstract
This article focuses on cutaneous hematopoietic neoplasms that are more likely to be encountered in the pediatric age-group and includes both lymphoproliferative and histiocytic disorders. The cutaneous hematologic disorders in children have a different epidemiologic profile to what is seen during adulthood. Although mycosis fungoides is the most frequent form of cutaneous lymphoma in adults, it is very rare in children. Because lymphoblastic leukemias and lymphomas are more frequent in the pediatric setting, cutaneous leukemic infiltrates are relatively common in this age-group. Similarly, histiocytic disorders are more common in children, particularly Langerhans cell histiocytosis and juvenile xanthogranuloma. Notably, the histiocytic disorders have undergone significant modifications on their nomenclature in the basis of the molecular characteristics that are present in them. A summary of the most frequent cutaneous hematopoietic disorders in children will be discussed further in this review.
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Affiliation(s)
- Alejandro A Gru
- 1 Department of Pathology, University of Virginia, Charlottesville, Virginia
| | - Louis P Dehner
- 2 Lauren V. Ackerman Laboratory of Surgical Pathology, St. Louis Children's Hospital and Dermatopathology, Washington University Medical Center, St. Louis, Missouri
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31
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Abstract
B-cell lymphomas represent approximately 20% to 25% of primary cutaneous lymphomas. Within this group, most cases (>99%) are encompassed by 3 diagnostic entities: primary cutaneous marginal zone lymphoma, primary cutaneous follicle center lymphoma, and primary cutaneous diffuse large B-cell lymphoma, leg type. In this article, the authors present clinical, histopathologic, immunophenotypic, and molecular features of each of these entities and briefly discuss the rarer intravascular large B-cell lymphoma.
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Affiliation(s)
- Charity B Hope
- Department of Pathology, UCSF Dermatopathology Section, University of California, San Francisco, 1701 Divisidero Street, Room 280, San Francisco, CA 94115, USA
| | - Laura B Pincus
- Department of Pathology, UCSF Dermatopathology Section, University of California, San Francisco, 1701 Divisidero Street, Room 280, San Francisco, CA 94115, USA; Department of Dermatology, UCSF Dermatopathology Section, University of California, San Francisco, 1701 Divisidero Street, Room 280, San Francisco, CA 94115, USA.
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32
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Abstract
T-cell lymphoma, a collection of subtypes of Non-Hodgkin lymphoma, is a rare malignancy. The low prevalence of this disease has made it challenging to identify subtype-specific risk factors. Potential risk factors could enable us to identify high-risk patients and predict patient outcomes. Here, we report on the current epidemiologic and prognostic factors data associated with the individual subtypes both of peripheral T-cell lymphoma (PTCL) and cutaneous T-cell lymphoma (CTCL) found in large cohort and case studies. Additionally, with recent findings, as well as updates in the new World Health Organization (WHO) classification of lymphoid neoplasms, we consider what this could do to change our approach to this group of diseases.
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33
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Virmani P, Levin L, Myskowski PL, Flores E, Marchetti MA, Lucas AS, Pulitzer M, Horwitz S, Trippett T, Moskowitz A, Querfeld C. Clinical Outcome and Prognosis of Young Patients with Mycosis Fungoides. Pediatr Dermatol 2017; 34:547-553. [PMID: 28804919 PMCID: PMC5653252 DOI: 10.1111/pde.13226] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND/OBJECTIVES Mycosis fungoides (MF) in young patients is rare and may have atypical presentations. There are limited data in these patients. The objective was to determine the clinical outcome and prognosis of young patients with MF. METHODS A search of our institutional cancer registry database was conducted for patients diagnosed with MF at younger than 30 years of age. RESULTS Our study included 74 patients (median age at diagnosis 25.5 yrs). Sixty-five (88%) presented with early stage disease and variants of MF (n = 44 [59%]), leading to a median delay in diagnosis of 2.5 years. Hypopigmented MF (n = 27 [36.5%]) was the most common variant, affecting predominantly African American (44.4% vs 19%; p = 0.02) and younger (20 vs 26 yrs; p < 0.001) patients. All patients with hypopigmented MF presented with early stage disease and were less likely to develop progressive disease (PD) than those with other variants (11% vs 34%; p = 0.03). Nineteen patients (26%) developed PD during a median follow-up of 3.5 years, which was associated with advanced-stage disease (89% vs 17%; p < 0.001), older age (>20 yrs) (31% vs 13%; p = 0.08), African American race (52.6% vs 20%; p = 0.009), and poikilodermatous presentation (p < 0.01). Overall survival was good (97.2% at 5 yrs, 95.9% at 10 yrs) despite the delay in diagnosis and atypical presentation. CONCLUSIONS Progressive disease is associated with older age, African American race, the poikilodermatous variant, and advanced-stage disease. The hypopigmented variant is a common presentation in young patients and has an indolent disease course. Our study confirms an overall favorable prognosis in young patients with MF.
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Affiliation(s)
- Pooja Virmani
- Department of Dermatology, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York
| | - Laura Levin
- Department of Dermatology, Weill Cornell Medical College, New York, New York
| | - Patricia L Myskowski
- Department of Dermatology, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York.,Department of Dermatology, Weill Cornell Medical College, New York, New York
| | - Eileen Flores
- Department of Dermatology, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York
| | - Michael A Marchetti
- Department of Dermatology, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York.,Department of Dermatology, Weill Cornell Medical College, New York, New York
| | - Anna Skripnik Lucas
- Department of Dermatology, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York
| | - Melissa Pulitzer
- Dermatopathology Service, Department of Pathology, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York
| | - Steven Horwitz
- Lymphoma Services, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York
| | - Tanya Trippett
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York
| | - Alison Moskowitz
- Lymphoma Services, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York
| | - Christiane Querfeld
- Department of Dermatology, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York.,Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, California.,Division of Dermatology, City of Hope Comprehensive Cancer Center, Duarte, California
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34
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35
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Shastry J, Ciliberto H. Recurrent Erythematous Papules and Nodules on the Trunk and Extremities of a 3-Year-Old Girl. Pediatr Dermatol 2017; 34:481-483. [PMID: 28686346 DOI: 10.1111/pde.13164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Heather Ciliberto
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
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36
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Kempf W. Cutaneous lymphomas in childhood and adolescence: much needed new data. Br J Dermatol 2017; 176:857-858. [PMID: 28418156 DOI: 10.1111/bjd.15217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- W Kempf
- Kempf und Pfaltz Histologische Diagnostik, Seminarstrasse 1, CH-8042, Zürich, Switzerland.,Department of Dermatology, University Hospital Zurich, CH-8091, Zürich, Switzerland
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37
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Amitay-Laish I, Tavallaee M, Kim J, Hoppe R, Million L, Feinmesser M, Fenig E, Wolfe M, Hodak E, Kim Y. Paediatric primary cutaneous marginal zone B-cell lymphoma: does it differ from its adult counterpart? Br J Dermatol 2017; 176:1010-1020. [DOI: 10.1111/bjd.14932] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2016] [Indexed: 12/13/2022]
Affiliation(s)
- I. Amitay-Laish
- Department of Dermatology; Davidoff Center; Rabin Medical Center - Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - M. Tavallaee
- Department of Dermatology; Stanford Cancer Center; Stanford CA U.S.A
| | - J. Kim
- Department of Pathology; Stanford Cancer Center; Stanford CA U.S.A
| | - R.T. Hoppe
- Department of Radiation Oncology; Stanford Cancer Center; Stanford CA U.S.A
| | - L. Million
- Department of Radiation Oncology; Stanford Cancer Center; Stanford CA U.S.A
| | - M. Feinmesser
- Department of Pathology; Davidoff Center; Rabin Medical Center - Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - E. Fenig
- Department of Radiotherapy Unit; Davidoff Center; Rabin Medical Center - Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - M.E.L. Wolfe
- Department of Dermatology; Stanford Cancer Center; Stanford CA U.S.A
| | - E. Hodak
- Department of Dermatology; Davidoff Center; Rabin Medical Center - Beilinson Hospital, Petach Tikva; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Y.H. Kim
- Department of Dermatology; Stanford Cancer Center; Stanford CA U.S.A
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38
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Hope CB, Pincus LB. Primary cutaneous B-cell lymphomas with large cell predominance-primary cutaneous follicle center lymphoma, diffuse large B-cell lymphoma, leg type and intravascular large B-cell lymphoma. Semin Diagn Pathol 2016; 34:85-98. [PMID: 28065463 DOI: 10.1053/j.semdp.2016.11.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In this review, we present clinical features and detailed histopathologic, immunologic, and molecular information regarding primary cutaneous follicle center lymphoma and primary cutaneous diffuse large B-cell lymphoma, leg type which together represent two of the three most common types of primary cutaneous B-cell lymphoma recognized in the current WHO classification system.1,2 Overall, B-cell lymphomas represent 19-27% of primary cutaneous lymphomas in most large European and American studies3-6 and together, primary cutaneous follicle center lymphoma and primary cutaneous diffuse large B-cell lymphoma, leg type account for approximately 2/3 to ¾ of these cases.5,7-11 Both subtypes can contain a high content of large B-lymphocytes, although most cases of primary cutaneous follicle center lymphomas exhibit a range in cell size and cytology. Intravascular large B-cell lymphoma, a less commonly-encountered EBV-negative primary cutaneous B-cell lymphoma composed of large cells, will be more briefly discussed in this report as well.
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Affiliation(s)
- Charity B Hope
- Department of Pathology, University of California San Francisco, USA
| | - Laura B Pincus
- Department of Pathology, University of California San Francisco, USA; Department of Dermatology, University of California San Francisco, USA.
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39
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Ceppi F, Pope E, Ngan B, Abla O. Primary Cutaneous Lymphomas in Children and Adolescents. Pediatr Blood Cancer 2016; 63:1886-94. [PMID: 27229270 DOI: 10.1002/pbc.26076] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/28/2016] [Accepted: 04/28/2016] [Indexed: 12/22/2022]
Abstract
Primary cutaneous lymphomas are rare in children and mostly represented by mycosis fungoides and CD30(+) lymphoproliferative disorders. Most pediatric cutaneous lymphomas have similar clinical/pathological features as their adult counterparts, particularly the T-cell subtypes. With regard to outcome, adult cutaneous mature T-cell lymphomas have a tendency to progression, while this appears to be relatively infrequent in children. The outcome of cutaneous B-cell lymphomas depends on subtype, with the B-lymphoblastic entity being associated with similar outcomes to precursor B acute lymphoblastic leukemia, while there are insufficient data on other entities. The diagnosis and treatment of these patients require a close collaboration between experienced pediatric pathologists, dermatologists, and oncologists. Prospective collection of longitudinal clinical and biological data from children with these rare lymphomas is needed to better understand their biological and clinical behavior and to ultimately discover the best therapeutic strategies.
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Affiliation(s)
- Francesco Ceppi
- Division of Hematology/Oncology, Department of Pediatrics, Hospital for Sick Children, Ontario, Toronto, Canada
| | - Elena Pope
- Division of Dermatology, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Bo Ngan
- Division of Pathology, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario
| | - Oussama Abla
- Division of Hematology/Oncology, Department of Pediatrics, Hospital for Sick Children, Ontario, Toronto, Canada.
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Alberti-Violetti S, Vezzoli P, Corti L, Fanoni D, Merlo V, Venegoni L, Reseghetti A, Berti E. Sézary Syndrome in a 17-Year-Old Boy: Clinicopathologic Features and Genomic Profile. Pediatr Dermatol 2016; 33:e318-21. [PMID: 27397596 DOI: 10.1111/pde.12930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We describe the case of a 17-year-old Hispanic boy who had had erythroderma and diffuse lymphadenopathy for approximately 6 months. A diagnosis of Sézary syndrome was made on the basis of the histologic features of the skin; the presence of the same T-cell clone on the skin, blood, and bone marrow; and the high CD4(+) lymphocyte count with an aberrant phenotype in peripheral blood; bone marrow involvement was also present. The patient was treated with systemic gemcitabine and achieved partial remission.
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Affiliation(s)
- Silvia Alberti-Violetti
- Unità Operativa Complessa Dermatologia, Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy.
| | - Pamela Vezzoli
- Unità Strutturale Complessa Dermatologia, Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Laura Corti
- Unità Operativa Complessa Dermatologia, Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniele Fanoni
- Unità Operativa Complessa Dermatologia, Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Valentina Merlo
- Unità Operativa Complessa Dermatologia, Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Luigia Venegoni
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - Alberto Reseghetti
- Unità Strutturale Complessa Dermatologia, Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Emilio Berti
- Unità Operativa Complessa Dermatologia, Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy.,Dipartimento di Scienze della Salute, Università degli Studi di Milano-Bicocca, Milan, Italy
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41
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Lopez-Lerma I, Navarro A, García-Patos V. A rapidly enlarging nodule on the scalp in an infant. Int J Dermatol 2016; 56:599-601. [DOI: 10.1111/ijd.13385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 04/28/2016] [Accepted: 05/10/2016] [Indexed: 12/30/2022]
Affiliation(s)
- Ingrid Lopez-Lerma
- Department of Dermatology; Hospital Universitari Vall d'Hebron; Barcelona Spain
| | - Alexandra Navarro
- Department of Pathology; Hospital Universitari Vall d'Hebron; Barcelona Spain
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Wieser I, Wohlmuth C, Nunez CA, Duvic M. Lymphomatoid Papulosis in Children and Adolescents: A Systematic Review. Am J Clin Dermatol 2016; 17:319-27. [PMID: 27138554 DOI: 10.1007/s40257-016-0192-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Lymphomatoid papulosis (LyP) is a lymphoproliferative disorder that is rare among adults and even rarer among children. In adults, LyP is associated with an increased risk of secondary lymphomas. OBJECTIVE The aim of this systematic review was to describe the clinical and histopathological features of LyP in children, to assess the risk of associated lymphomas, and to compare the disease to the adult form. METHODS A systematic review was conducted using the MEDLINE (PubMed), EMBASE, Scopus, and Cochrane databases from inception to June 2015. Articles were included if data were extractable from studies, case series, and single reports of pediatric LyP patients. RESULTS A total of 251 children and adolescents with LyP were identified, with the mean age at diagnosis being 9.3 ± 4.6 years (n = 187). The female to male ratio was 1:1.4, and the majority of children reported on were Caucasian (n = 74, 85.1 %). The predominant histologic subtype was type A (n = 106, 79.1 %). Clinically, LyP lesions presented as erythematous papules or nodules, appearing preferentially on the extremities and the trunk. LyP has to be differentiated from pityriasis lichenoides (PL) and primary cutaneous anaplastic large cell lymphoma (ALCL). PL and associated lymphomas were diagnosed before, with, and after LyP in 19 and 14 cases, respectively. Of the 14 subjects with associated lymphomas, two children developed systemic ALCL. CONCLUSION LyP has to be differentiated from ALCL to avoid erroneous treatments. Due to the increased risk of development of non-Hodgkin lymphomas, lifelong follow-up and proper patient counseling are warranted.
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