Hypopigmented Mycosis Fungoides with Large Cell Transformation in a Child. Issue 5 (14th August 2017)

• Record Type: Journal Article
• Authors: Pradhan, Dinesh; Jedrych, Jaroslaw J.; Ho, Jonhan; Akilov, Oleg E.
• Is Part Of: Pediatric dermatology. Volume 34:Issue 5(2017:Sep./Oct.)
• Page Start: e260
• Page End: e264
• Publication Date: 2017-08-14
• Subjects: Pediatric dermatology -- Periodicals; Children -- Diseases -- Periodicals; 618.925
• DOI: 10.1111/pde.13233
• Languages: English
• ISSNs: 0736-8046

Abstract

Abstract: Hypopigmented mycosis fungoides (HMF) is the most common variant of mycosis fungoides (MF) in children. Large‐cell transformation in HMF has never been reported. Herein we report a case of HMF in an 8‐year‐old boy who presented with a 6‐year history of hypopigmented patches on the bilateral arms, lower back, buttocks, posterior thighs, and lower legs. Biopsy revealed an abnormal CD8 + epidermotropic T‐cell infiltrate consistent with the diagnosis of MF. The T‐cell clonality study was positive. The patient was started on narrowband ultraviolet B (NBUVB) phototherapy and topical steroids. He had a 50% reduction in his patches after 10 months of treatment, after which he developed a single annular plaque on his left thigh. The biopsy specimen demonstrated large cells that were diffusely CD8 + and CD30 − . Clobetasol propionate ointment was prescribed, which led to complete resolution of the plaque within 2 weeks. NBUVB phototherapy was continued and the patient had a complete response within the following 5 months. The case is an example of exceptionally rare large‐cell transformation in pediatric MF and stresses the importance of regular follow‐up of these patients.