Case and Research Letters
Pityriasis Lichenoides in a 9-Month-Old Boy
Pitiriasis Liquenoide en un Lactante De 9 Meses
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López-Villaescusa, Á. Hernández-Martín, I. Colmenero, A. Torrelo" "autores" => array:4 [ 0 => array:3 [ "nombre" => "M.T." "apellidos" => "López-Villaescusa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Á." "apellidos" => "Hernández-Martín" "email" => array:1 [ 0 => "ahernandez_hnj@yahoo.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "I." "apellidos" => "Colmenero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "A." "apellidos" => "Torrelo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Infantil Niño Jesús, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Infantil Niño Jesús, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pitiriasis Liquenoide en un Lactante De 9 Meses" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 694 "Ancho" => 1600 "Tamanyo" => 389884 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Deep perivascular lymphohistiocytic inflammatory infiltrate with involvement of the dermal-epidermal junction (hematoxylin-eosin, original magnification ×10). B, Detail showing interface alteration, fibrinoid necrosis in the vessel walls, and isolated necrotic keratinocytes (hematoxylin-eosin, original magnification ×40).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Pityriasis lichenoides (PL) is a skin disease of unknown origin that is characterized by scaling papules. It is relatively common in childhood but very rare in the first year of life, with just 9 cases described in the literature.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We report the case of a 9-month-old boy with no personal or family history of interest who was seen in our department for generalized skin lesions that had been present for a week. The patient was afebrile and had no other symptoms or known history of prior infection. Physical examination revealed papular scaling, erythematous-brownish lenticular lesions on the trunk and proximal extremities (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). There was no mucosal involvement and the physical examination was otherwise normal. Histology showed a deep, perivascular lymphohistiocytic inflammatory infiltrate, with fibrinoid necrosis in the vessel walls and involvement of the dermal-epidermal junction. In the epidermis there was diffuse parakeratosis, focal exocytosis, isolated necrotic keratinocytes, and small foci of necrosis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Immunohistochemical staining with anti-S100 protein and CD1 antibodies was negative. Based on the clinical and histologic findings, we diagnosed PL and prescribed topical corticosteroid therapy (methylprednisolone aceponate), which resulted in slight improvement of the lesions. The condition improved spontaneously over the following months, leaving residual postinflammatory hypopigmented macules.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">PL is an inflammatory disease of unknown origin. There have been some reports of T-cell clonality, suggesting that the condition is either the result of an immune response to an as yet unidentified infectious agent or a cutaneous T-cell lymphoproliferative disorder.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> However, because progression to cutaneous T-cell lymphoma is so rare in children, additional genetic factors would probably need to be present. There are 2 clinical variants of PL: pityriasis lichenoides chronica and pityriasis lichenoides et varioliformis acuta (PLEVA). However, acute and chronic lesions may coexist. Histologic findings may also vary according to the clinical variant, but they do not always correlate with clinical morphology. Prognosis is excellent, and while PL can last for months, or even years, progression to T-cell lymphoma is very rare.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">PL can occur at any age, but it is particularly common in children, with incidence peaking at 2, 5, 10, and 12 years of age.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> It is very rare in the first year of life. In our review of the literature, we found only 9 cases of onset before the age of 12 months. These included 1 congenital case,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> 3 cases with onset at 8 months of age,<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5–7</span></a> and 1 case with onset at 11 months of age.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> We also found mention of an additional 4 cases in children aged under 1 year in a retrospective study of 124 children with PL.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In the 9 cases described in the literature, all the patients (8 boys and 1 girl) were otherwise healthy. There was just 1 case with a history of previous infection, in which pneumococci and <span class="elsevierStyleItalic">Haemophilus influenza</span> were isolated.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Six of the patients had lesions clinically consistent with PLEVA, with ulceronecrotic lesions that resolved with topical corticosteroid therapy in a maximum of 2 months.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,7,8</span></a> The remaining 3 patients had lesions that were clinically and histologically consistent with PL chronica.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4–6</span></a> The disease followed an indolent course in 2 patients, 1 of whom developed an indurated plaque in the right iliac fossa after a year and a half. The plaque was initially compatible with lymphomatoid papulosis but 2 years later, it was histologically diagnosed as cutaneous T-cell lymphoma.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> The second patient developed parapsoriasis at 10 years of follow-up.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Given the scarcity of cases in the literature, no clear conclusions can be drawn, but based on our review, PL would appear to be very rare in children under 12 months of age, with just 10 cases, including ours, reported to date. Within this age group, PL is more common in boys and tends to occur in an acute form and to resolve spontaneously without complications. Nevertheless, given the possible association with lymphoproliferative disorders, long-term monitoring is recommended.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: López-Villaescusa MT, Hernández-Martín Á, Colmenero I, Torrelo A. Pitiriasis liquenoide en un lactante de 9 meses. Actas Dermosifiliogr. 2013;104:829–830.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1115 "Ancho" => 1583 "Tamanyo" => 174670 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Erythematous, scaling papules on the trunk and proximal extremities.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 694 "Ancho" => 1600 "Tamanyo" => 389884 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Deep perivascular lymphohistiocytic inflammatory infiltrate with involvement of the dermal-epidermal junction (hematoxylin-eosin, original magnification ×10). B, Detail showing interface alteration, fibrinoid necrosis in the vessel walls, and isolated necrotic keratinocytes (hematoxylin-eosin, original magnification ×40).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "T-Cell clonality in pityriasis lichenoides et varioliformis acuta: a heteroduplex analysis of 20 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "O. Dereure" 1 => "E. Levi" 2 => "M.E. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 9 | 5 | 14 |
| 2024 Octubre | 77 | 50 | 127 |
| 2024 Septiembre | 79 | 23 | 102 |
| 2024 Agosto | 109 | 43 | 152 |
| 2024 Julio | 94 | 38 | 132 |
| 2024 Junio | 100 | 48 | 148 |
| 2024 Mayo | 101 | 25 | 126 |
| 2024 Abril | 73 | 19 | 92 |
| 2024 Marzo | 91 | 28 | 119 |
| 2024 Febrero | 74 | 32 | 106 |
| 2024 Enero | 55 | 28 | 83 |
| 2023 Diciembre | 68 | 21 | 89 |
| 2023 Noviembre | 67 | 31 | 98 |
| 2023 Octubre | 83 | 20 | 103 |
| 2023 Septiembre | 87 | 30 | 117 |
| 2023 Agosto | 57 | 19 | 76 |
| 2023 Julio | 74 | 32 | 106 |
| 2023 Junio | 75 | 26 | 101 |
| 2023 Mayo | 109 | 24 | 133 |
| 2023 Abril | 86 | 36 | 122 |
| 2023 Marzo | 97 | 32 | 129 |
| 2023 Febrero | 63 | 25 | 88 |
| 2023 Enero | 60 | 27 | 87 |
| 2022 Diciembre | 69 | 41 | 110 |
| 2022 Noviembre | 54 | 42 | 96 |
| 2022 Octubre | 44 | 29 | 73 |
| 2022 Septiembre | 45 | 42 | 87 |
| 2022 Agosto | 33 | 36 | 69 |
| 2022 Julio | 34 | 41 | 75 |
| 2022 Junio | 38 | 50 | 88 |
| 2022 Mayo | 49 | 39 | 88 |
| 2022 Abril | 50 | 49 | 99 |
| 2022 Marzo | 71 | 51 | 122 |
| 2022 Febrero | 62 | 36 | 98 |
| 2022 Enero | 65 | 44 | 109 |
| 2021 Diciembre | 43 | 34 | 77 |
| 2021 Noviembre | 58 | 53 | 111 |
| 2021 Octubre | 50 | 50 | 100 |
| 2021 Septiembre | 36 | 50 | 86 |
| 2021 Agosto | 59 | 35 | 94 |
| 2021 Julio | 38 | 26 | 64 |
| 2021 Junio | 45 | 28 | 73 |
| 2021 Mayo | 34 | 30 | 64 |
| 2021 Abril | 79 | 40 | 119 |
| 2021 Marzo | 43 | 24 | 67 |
| 2021 Febrero | 39 | 27 | 66 |
| 2021 Enero | 28 | 19 | 47 |
| 2020 Diciembre | 30 | 16 | 46 |
| 2020 Noviembre | 43 | 18 | 61 |
| 2020 Octubre | 30 | 12 | 42 |
| 2020 Septiembre | 24 | 7 | 31 |
| 2020 Agosto | 37 | 26 | 63 |
| 2020 Julio | 23 | 16 | 39 |
| 2020 Junio | 34 | 25 | 59 |
| 2020 Mayo | 19 | 20 | 39 |
| 2020 Abril | 29 | 25 | 54 |
| 2020 Marzo | 35 | 15 | 50 |
| 2020 Febrero | 4 | 0 | 4 |
| 2020 Enero | 0 | 2 | 2 |
| 2019 Diciembre | 4 | 4 | 8 |
| 2019 Noviembre | 0 | 4 | 4 |
| 2019 Septiembre | 4 | 7 | 11 |
| 2019 Agosto | 0 | 6 | 6 |
| 2019 Julio | 0 | 11 | 11 |
| 2019 Junio | 2 | 10 | 12 |
| 2019 Mayo | 0 | 10 | 10 |
| 2019 Abril | 0 | 11 | 11 |
| 2019 Marzo | 2 | 8 | 10 |
| 2019 Febrero | 2 | 5 | 7 |
| 2019 Enero | 1 | 0 | 1 |
| 2018 Diciembre | 0 | 8 | 8 |
| 2018 Noviembre | 1 | 0 | 1 |
| 2018 Octubre | 2 | 0 | 2 |
| 2018 Septiembre | 1 | 0 | 1 |
| 2018 Marzo | 1 | 1 | 2 |
| 2018 Febrero | 39 | 1 | 40 |
| 2018 Enero | 45 | 7 | 52 |
| 2017 Diciembre | 36 | 5 | 41 |
| 2017 Noviembre | 44 | 3 | 47 |
| 2017 Octubre | 28 | 3 | 31 |
| 2017 Septiembre | 40 | 6 | 46 |
| 2017 Agosto | 53 | 3 | 56 |
| 2017 Julio | 31 | 5 | 36 |
| 2017 Junio | 51 | 5 | 56 |
| 2017 Mayo | 45 | 15 | 60 |
| 2017 Abril | 45 | 10 | 55 |
| 2017 Marzo | 37 | 14 | 51 |
| 2017 Febrero | 26 | 8 | 34 |
| 2017 Enero | 23 | 7 | 30 |
| 2016 Diciembre | 39 | 6 | 45 |
| 2016 Noviembre | 50 | 12 | 62 |
| 2016 Octubre | 71 | 9 | 80 |
| 2016 Septiembre | 133 | 11 | 144 |
| 2016 Agosto | 75 | 6 | 81 |
| 2016 Julio | 34 | 8 | 42 |
| 2016 Junio | 8 | 14 | 22 |
| 2016 Mayo | 9 | 8 | 17 |
| 2016 Abril | 6 | 5 | 11 |
| 2016 Marzo | 5 | 1 | 6 |
| 2016 Febrero | 7 | 9 | 16 |
| 2016 Enero | 12 | 11 | 23 |
| 2015 Diciembre | 4 | 5 | 9 |
| 2015 Noviembre | 9 | 7 | 16 |
| 2015 Octubre | 10 | 11 | 21 |
| 2015 Septiembre | 7 | 1 | 8 |
| 2015 Agosto | 4 | 1 | 5 |
| 2015 Julio | 40 | 5 | 45 |
| 2015 Junio | 37 | 9 | 46 |
| 2015 Mayo | 50 | 9 | 59 |
| 2015 Abril | 25 | 15 | 40 |
| 2015 Marzo | 19 | 26 | 45 |
| 2015 Febrero | 33 | 2 | 35 |
| 2015 Enero | 26 | 3 | 29 |
| 2014 Diciembre | 26 | 3 | 29 |
| 2014 Noviembre | 16 | 7 | 23 |
| 2014 Octubre | 30 | 6 | 36 |
| 2014 Septiembre | 31 | 2 | 33 |
| 2014 Agosto | 22 | 3 | 25 |
| 2014 Julio | 9 | 5 | 14 |
| 2014 Junio | 44 | 2 | 46 |
| 2014 Mayo | 31 | 5 | 36 |
| 2014 Abril | 22 | 11 | 33 |
| 2014 Marzo | 26 | 3 | 29 |
| 2014 Febrero | 20 | 5 | 25 |
| 2014 Enero | 18 | 3 | 21 |
| 2013 Diciembre | 26 | 3 | 29 |
| 2013 Noviembre | 24 | 5 | 29 |
| 2013 Octubre | 1 | 0 | 1 |
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