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Hypopigmented Mycosis Fungoides with Large Cell Transformation in a Child
Author(s) -
Pradhan Dinesh,
Jedrych Jaroslaw J.,
Ho Jonhan,
Akilov Oleg E.
Publication year - 2017
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.13233
Subject(s) - mycosis fungoides , medicine , buttocks , dermatology , biopsy , hypopigmentation , cryotherapy , pathology , lymphoma , surgery
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 CD 8 + 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 CD 8 + and CD 30 − . 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.