A Case Report of Pityriasis Lichenoides- Like Mycosis Fungoides in Children: A Challenging Diagnosis
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Primary cutaneous lymphomas are rare diseases among the general population, and even rarer in children. Mycosis fungoides (MF) is the most commonly diagnosed form in childhood. Several atypical clinical variants of MF have been reported, and pityriasis lichenoides-like MF (PL-like MF) is a recently described subtype. We report about a rare case of PL-like MF in an 11-year-old Malay boy with a 2-year history of multiple scaly erythematous papules associated with progressive and generalized hypopigmentation. This case report illustrates the significant dilemma in the diagnosis of the disease, particularly in the early stages, because its symptoms can mimic those of many common childhood inflammatory skin disorders. Later, the widespread hypopigmentation obscured the characteristic lesions, leading to misdiagnosis. Moreover, due to unfamiliarity of the disease, the diagnosis of PLlike MF was missed and delayed until only 2 years after the onset of the dermatosis. Therefore, primary care practitioners must have a high index of suspicion for this cutaneous neoplasm in children with persistent or worsening skin lesions, not responding to standard therapy, to ensure timely referral, diagnosis, and treatment.
Abstract
Primary cutaneous lymphomas are rare diseases among the general population, and even rarer in children. Mycosis fungoides (MF) is the most commonly diagnosed form in childhood. Several atypical clinical variants of MF have been reported, and pityriasis lichenoides-like MF (PL-like MF) is a recently described subtype. We report about a rare case of PL-like MF in an 11-year-old Malay boy with a 2-year history of multiple scaly erythematous papules associated with progressive and generalized hypopigmentation. This case report illustrates the significant dilemma in the diagnosis of the disease, particularly in the early stages, because its symptoms can mimic those of many common childhood inflammatory skin disorders. Later, the widespread hypopigmentation obscured the characteristic lesions, leading to misdiagnosis. Moreover, due to unfamiliarity of the disease, the diagnosis of PLlike MF was missed and delayed until only 2 years after the onset of the dermatosis. Therefore, primary care practitioners must have a high index of suspicion for this cutaneous neoplasm in children with persistent or worsening skin lesions, not responding to standard therapy, to ensure timely referral, diagnosis, and treatment.
참고문헌 (10)
- Fitzpatrick TB, "Fitzpatrick’s dermatology in general medicine" (2008), MacGraw-Hill
- Jawed SI, "Primary cutaneous T-cell lymphoma(mycosis fungoides and Sezary syndrome) : part I : diagnosis : clinical and histopathologic features and new molecular and biologic markers", J Am Acad Dermatol, 70, pp.205~ (2014)
- Ahn CS, "Mycosis fungoides : an updated review of clinicopathologic variants", Am J Dermatopathol, 36, pp.933~948 (2014)
- 장민수, "Pityriasis Lichenoides-like Mycosis Fungoides: Clinical and Histologic Features and Response to Phototherapy", Annals of Dermatology, 28(5), pp.540~547 (2016), 대한피부과학회
- Ko JW, "Pityriasis lichenoides-like mycosis fungoides in children", Br J Dermatol, 142, pp.347~352 (2000)
- Lane TN, "Pityriasis lichenoides chronica in black patients", Cutis, 85, pp.125~129 (2010)
- De Unamuno Bustos B, "Adult pityriasis lichenoides-like mycosis fungoides : a clinical variant of mycosis fungoides", Int J Dermatol, 53, pp.1331~1338 (2014)
- Lin TL, "Pityriasis lichenoid-like mycosis fungoides in a 9-year-old boy : a case report", Acta Dermatovenerol Croat, 27, pp.37~39 (2019)
- Zaaroura H, "Relationship between pityriasis lichenoides and mycosis fungoides: a clinicopathological, immunohistochemical, and molecular study", Am J Dermatopathol, 40, pp.409~415 (2018)
- Boos MD, "Pityriasis lichenoides and cutaneous T cell lymphoma : an update on the diagnosis and management of the most common benign and malignant cutaneous lymphoproliferative diseases in children", Curr Dermatol Rep, 2, pp.203~211 (2013)