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Vol. 101. Issue 8.
Pages 693-701 (October 2010)
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Vol. 101. Issue 8.
Pages 693-701 (October 2010)
Original article
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Lymphomatoid Papulosis in Children: Report of 9 Cases and Review of the Literature
Papulosis linfomatoide en la infancia: presentación de 9 casos y revisión de la literatura
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A. Martorell-Calatayuda,
Corresponding author
antmarto@hotmail.com

Corresponding author.
, A. Hernández-Martína, I. Colmenerob, S. Vañó-Galvána, C. López-Obregóna, A. Armanda, M. Gambra Arzozc, A. Torreloa
a Servicio de Dermatología, Hospital Infantil Niño Jesús, Madrid, Spain
b Servicio de Anatomía Patológica, Hospital Infantil Niño Jesús, Madrid, Spain
c Servicio de Pediatría, Hospital Infantil Niño Jesús, Madrid, Spain
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Abstract
Background

Lymphomatoid papulosis is a rare CD30+ T-cell lymphoproliferative disease with an excellent prognosis. It is usually seen in adults and is rare in children. The clinical and pathologic manifestations and the risk of progression to other types of lymphoma are thus not clearly defined in the pediatric age group.

Objective

To describe the characteristics of lymphomatoid papulosis in a group of children and perform a review of the literature.

Patients and methods

A retrospective study was performed of 9 patients under 18 years of age diagnosed with lymphomatoid papulosis and treated in our department between 1995 and 2009

Results

The study included 7 boys and 2 girls aged between 2 and 17 years. Lesions compatible with pityriasis lichenoides acuta appeared before the lymphomatoid papulosis in 2 cases and afterwards in 1 case. The lymphomatoid papulosis lesions resolved spontaneously, leaving postinflammatory hyperpigmentation (77%) or hypopigmentation (23%). Scarring occurred in 77% of cases. Histologically, all cases showed features compatible with lymphomatoid papulosis type A. Molecular studies showed monoclonality in all 3 cases in which this technique was performed.

Conclusions

Lymphomatoid papulosis is a rare disease in childhood and the manifestations are similar to the adult form. This lymphoproliferative disease, occasionally associated with pityriasis lichenoides acuta, has histological features compatible with a type A or histiocytoid pattern. Progression to other lymphoproliferative disorders during followup is less common in the childhood form than in adults. The frequent association of pityriasis lichenoides acuta and lymphomatoid papulosis observed in our study, and the difficulty distinguishing between these 2 conditions in some cases, suggest that these diseases could be part of a single clinical-pathological spectrum.

Keywords:
Cutaneous T-cell lymphoma
Lymphomatoid papulosis
Childhood
Resumen
Introducción

La papulosis linfomatoide es un proceso linfoproliferativo de células T CD30+ poco frecuente y de pronóstico excelente que generalmente afecta a adultos y, en menor medida a niños, por lo que tanto el espectro clínico-patológico como el riesgo de progresión a otro tipo de linfoma en el grupo pediátrico no están bien establecidos.

Objetivo

Analizar las características de la papulosis linfomatoide infantil a partir de la descripción de nuevos casos y de la revisión de la literatura.

Material y método

Se realizó un estudio retrospectivo de 9 pacientes menores de 18 años diagnosticados de papulosis linfomatoide atendidos en nuestro servicio entre 1995 y 2009.

Resultados

Se incluyeron 7 niños y 2 niñas de edades entre 2 y 17 años. Las lesiones de papulosis linfomatoide se vieron precedidas en 2 casos y seguidas en 1 de otras compatibles con pitiriasis liquenoide aguda.

La resolución de las lesiones fue espontánea, dejando hiperpigmentación (77%) o hipopigmentación postinflamatoria (23%) y cicatrices en el 77% de los casos. Histológicamente todos los casos presentaron el patrón tipo A de papulosis linfomatoide. El estudio molecular mostró monoclonalidad en los 3 casos en los que fue realizado.

Conclusiones

La papulosis linfomatoide infantil es una entidad rara que se manifiesta clínicamente como la forma adulta. Esta enfermedad linfoproliferativa, que ocasionalmente se asocia a pitiriasis liquenoide aguda, muestra hallazgos histológicos compatibles con el patrón histiocitoide o tipo A. El desarrollo de otros procesos linfoproliferativos malignos en el seguimiento posterior es menos frecuente en la papulosis linfomatoide infantil comparado con la variante adulta. La frecuente asociación de pitiriasis liquenoide y de papulosis linfomatoide encontrada en nuestro análisis, así como la dificultad que supone en algunos casos el diferenciar entre ambos procesos, permiten sugerir que ambas patologías podrían formar parte de un espectro clínico-patológico común.

Palabras clave:
Linfoma cutáneo de células T
Papulosis linfomatoide
Infancia
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References
[1.]
W.L. Macaulay.
Lymphomatoid papulosis: A continuing selfhealing eruption, clinically benign-histologically malignant.
Arch Dermatol, 97 (1968), pp. 23-30
[2.]
R. Willemze, H. Kerl, W. Sterry, E. Berti, L. Cerroni, S. Chimenti, et al.
EORTC classification for primary cutaneous lymphomas: a proposal from the Cutaneous Lymphoma Study Group of the European Organization for Research and Treatment of Cancer.
Blood, 90 (1997), pp. 354-371
[3.]
L. El Shabrawi-Caelen, H. Kerl, L. Cerroni.
Lymphomatoid papulosis: reappraisal of clinicopathologic presentation and classification into subtypes A, B and C.
Arch Dermatol, 140 (2004), pp. 441-447
[4.]
R.C. Beljaards, R. Willemze.
The prognosis of patients with lymphomatoid papulosis associated with malignant lymphomas.
Br J Dermatol, 126 (1992), pp. 596-602
[5.]
F. Van Neer, J. Toonstra, P.C. Van Voorst Vader, R. Willemze, W.A. Van Vloten.
Lymphomatoid papulosis in children: a study of 10 children registered by the Dutch Cutaneous Lymphoma Working Group.
Br J Dermatol, 144 (2001), pp. 351-354
[6.]
T. Nijsten, C.C. Curiel-Lewandrowski, M.E. Kadin.
Lymphomatoid papulosis in children: a retrospective cohort study of 35 cases.
Arch Derm, 140 (2004), pp. 306-312
[7.]
A. De Souza, M.J. Camilleri, D.A. Wada, D.L. Appert, L.E. Gibson, R.A. el-Azhary.
Clinical, histopathologic, and immunophenotypic features of lymphomatoid papulosis with CD8 predominance in 14 pediatric patients.
J Am Acad Dermatol, 61 (2009), pp. 993-1000
[8.]
R. Fink-Puches, A. Chott, M. Ardigó, I. Simonitsch, G. Ferrara, H. Kerl, et al.
The spectrum of cutaneous lymphomas in patients less than 20 years of age.
Pediatr Dermatol, 21 (2004), pp. 525-533
[9.]
N. Bories, L. Thomas, A. Phan, B. Balme, D. Salameire, C. Thurot-Guillou, et al.
Lymphomatoid papulosis in childhood: six case reports and literature review.
Ann Dermatol Venereol, 135 (2008), pp. 657-662
[10.]
G.M. Zirbel, S.E. Gellis, M.E. Kadin, N.B. Esterly.
Lymphomatoid papulosis in children.
J Am Acad Dermatol, 33 (1995), pp. 741-748
[11.]
C. Serra-Guillén, C. Requena, A. Alfaro, L. Hueso, O. Sanmartín, B. Llombart, et al.
Oral involvement in lymphomatoid papulosis.
Actas Dermosifiliogr, 98 (2007), pp. 265-267
[12.]
M.W. Bekkenk, F.A. Geelen, P.C. van Voorst Vader, F. Heule, M.L. Geerts, W.A. van Vloten, et al.
Primary and secondary cutaneous CD30+ lymphoproliferative disorders: a report from the Dutch Cutaneous Lymphoma Group on the long-term follow-up data of 219 patients and guidelines for diagnosis and treatment.
Blood, 95 (2000), pp. 3653-3661
[13.]
J. Ashworth, W.D. Paterson, R.M. MacKie.
Lymphomatoid papulosis/pityriasis lichenoides in two children.
Pediatr Dermatol, 4 (1987), pp. 238-241
[14.]
R. Willemze, R.C. Beljaards.
Spectrum of primary cutaneous CD30 (Ki-1)-positive lymphoproliferative disorders. A proposal for classification and guidelines for management and treatment.
J Am Acad Dermatol, 28 (1993), pp. 973-980
[15.]
M.A. Barnadas, D.L. Lopez, R.M. Pujol, V. García-Patos, R. Curell, J.M. de Moragas.
Pustular lymphomatoid papulosis in childhood.
J Am Acad Dermatol, 27 (1992), pp. 627-628
Copyright © 2010. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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