Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2023; 22: 113-122
Клинический случай грибовидного микоза 113 у ребенка 11 лет
https://doi.org/10.24287/1726-1708-2023-22-2-113-122Аннотация
Первичные кожные лимфомы довольно редко встречаются у детей. Клинические и гистопатологические проявления этих заболеваний у пациентов детского возраста могут значительно отличаться от таковых у взрослых. Из-за их редкости и сложной клинической картины диагностика может быть очень длительной. Грибовидный микоз (ГМ) является наиболее часто диагностируемой формой первичных кожных лимфом в детском возрасте. Клинических рекомендаций для лечения детей не существует. В литературе данные о вариантах ГМ у детей немногочисленны, наиболее крупное исследование включает 34 пациента, у которых диагноз был поставлен в среднем через 4 года после появления первых симптомов. В данной статье мы представляем клинический случай ГМ у 11-летнего ребенка с 8-летней историей множественного поражения кожных покровов и кожи головы. Родители пациента дали согласие на использование информации, в том числе фотографий ребенка, в научных исследованиях и публикациях.
Целью нашей публикации является демонстрация проблем в диагностике заболевания, особенно на ранних стадиях, поскольку его симптомы могут быть похожи на симптомы многих распространенных детских воспалительных заболеваний кожи.
Список литературы
1. Fitzpatrick T. B., Friedberg I. M. Fitzpatrick's Dermatology in General Medicine. 8th ed. New York (NY): MacGraw-Hill; 2008.
2. Jawed S. I., Myskowski P. L., Horwitz S., Moskowitz A., Querfeld C. Primary cutaneous T-cell lymphoma (mycosis fungoides and Cesari syndrome): part I: diagnosis: clinical and histopathological features and new molecular and biological markers. J Am Acad Dermatol 2014; 70 (2): 205. e1-16; quiz 221–2. DOI: 10.1016/j.jaad.2013.07.049
3. Ahn C. S., ALSayyakh A., Sangeza O. P. Mycosis fungoides: an updated review of clinicopathological variants. Am J Dermatopatol 2014; 36 (12): 933–48.
4. Horwitz S. M., Olsen E. A., Duvic M., Porcu P., Kim Y. H. Review of the treatment of mycosis fungoides and Sézary syndrome: a stage-based approach. J Natl Compr Canc Netw 2008; 6 (4): 436–42.
5. Jang M. S., Kang D. Y., Park J. B., Kim J. H., Park K. A., Rim H., et al. Mycosis fungoides resembling lichenoid pityriasis versicolor: clinical and histological features and response to phototherapy. Ann Dermatol 2016; 28: 540–7.
6. Ko J. W., Seong J. Y., Suh K. S., Kim S. T. Pityriasis lichenoides-like mycosis fungoides in children. Br J Dermatol. 2000; 142 (2): 347–52.
7. Fink-Puches R., Chott A., Ardigo M., Simonitsch I., Ferrara G., Kerl H., Cerroni L. The spectrum of cutaneous lymphomas in patients less than 20 years of age. Pediatr Dermatol 2004; 21 (5): 525–53.
8. Ceppi F., Pope E., Ngan B., Abla O. Primary cutaneous lymphomas in children and adolescents. Pediatr Blood Cancer 2016; 63 (11): 1886–94.
9. Ocampo O. V., Julio L., Zapata V., Correa L. A., Vasco C., Correa S., Velásquez-Lopera M. M. Mycosis fungoides in children and adolescents: a series of 23 cases. Actas Dermosifiliogr (Engl Ed) 2020; 111 (2): 149–56.
10. Hodak E., Amitay-Laish I., Feinmesser M., Davidovici B., David M., Zvulunov A., et al. Juvenile mycosis fungoides: cutaneous T-cell lymphoma with frequent follicular involvement. J Am Acad Dermatol 2014; 70 (6): 993– 1001.
11. Boulos S., Vaid R., Aladily T. N., Ivan D. S., Talpur R., Duvic M. Clinical presentation, immunopathology, and treatment of juvenile-on-set mycosis fungoides: a case series of 34 patients. J Am Acad Dermatol 2014; 71 (6): 1117–26.
12. Rodney I. J., Kindred C., Angra K., Qutub O. N., Villanueva A. R., Halder R. M. Hypopigmented mycosis fungoides: a retrospective clinicohistopathologic study. J Eur Acad Dermatol Venereol 2017; 31 (5): 808–14.
13. Fatima S., Siddiqui S., Tariq M. U., Ishtiaque H., Idrees R., Ahmed Z., Ahmed A. Mycosis fungoides: a clinicopathological study of 60 cases from a tertiary care center. Indian J Dermatol 2020; 65 (2): 123–9.
14. Jung J. M., Lim D. J., Won C. H., Chang S. E., Lee M. W., Lee W. J. Mycosis fungoides in children and adolescents: a systematic review. JAMA Dermatol 2021; 157 (4): 431–8.
15. Reiter O., Amitai D. B., Amitay-Laish I., Israeli M., Pavlovsky L., Hodak E. Pediatric mycosis fungoides: a study of the human leukocyte antigen system among Israeli Jewish patients. Arch Dermatol Res 2017; 309 (10): 851–6.
16. Nasimi M., Kamyab K., Aghahi T., Fahim S., Ghandi N. Childhood mycosis fungoides: a clinicopathologic study of 30 cases from Iran. Aust J Dermatol 2020; 61: e259–61.
17. Heng Y. K., Koh M. J. А., Giam Y. C., Tang M. B. Y., Chong W. S., Tan S. H. Pediatric mycosis fungoides in Singapore: a series of 46 children. Pediatr Dermatol 2014; 31 (4): 477–82.
18. Koh M. J.-A., Chong W.-S. Narrow-band ultraviolet B phototherapy for mycosis fungoides in children. Clin Exp Dermatol 2014; 39: 474–8.
19. Alsuwaidan S. N. Childhood mycosis fungoides: new observations from the Middle East. J Saudi Soc Dermatol Dermatol Surg 2012; 16: 5–8.
20. Virmani P., Levin L., Myskowski P. L., Flores E., Marchetti M. A., Skripnik Lucas A., et al. Clinical outcome and prognosis of young patients with mycosis fungoides. Pediatr Dermatol 2017; 34: 547–53.
21. Kim S. T., Sim H. J., Jeon Y. S., Lee J.-W., Roh H.-J., Choi S.-Y., et al. Clinicopathological features and T-cell receptor gene rearrangement findings of mycosis fungoides in patients younger than age 20 years. J Dermatol 2009; 36: 392–402.
22. Nanda A., Al Saleh Q. A., Al-Ajmi H., Al-Sabah H., Elkashlan M., Al-Shemmari S., Demierre M.-F., et al. Mycosis fungoides in Arab children and adolescents: a report of 36 patients from Kuwait. Pediatr Dermatol 2010; 27: 607–13.
23. Wain E. M., Orchard G. E., Whittaker S. J., Spittle M. Sc. M. F., Russell-Jones R. Outcome in 34 patients with juvenile-onset mycosis fungoides: a clinical, immunophenotypic, and molecular study. Cancer 2003; 98 (10): 2282–90.
24. Reiter O., Amitai D. B., Amitay-Laish I., Israeli М., Pavlovsky L., Hodak E. Pediatric mycosis fungoides: a study of the human leukocyte antigen system among Israeli Jewish patients. Arch Dermatol Res 2017; 309 (10): 851–6.
25. Hanna S., Walsh N., D'Intino Y., Langley R. G. B. Mycosis fungoides presenting as pigmented purpuric dermatitis. Pediatr Dermatol 2006; 23: 350–4.
26. Cervini A. B., Torres-Huamani A. N., Sanchez-La-Rosa C., Galluzzo L., Solernou V., Digiorge J., Rubio P. Mycosis fungoides: experience in a pediatric hospital. Actas Dermosifiliográficas (Engl Ed) 2017; 108 (6): 564–70.
27. Мякова Н. В. Редкий случай грибовидного микоза у детей. Собственное наблюдение и обзор литературы / Н. В. Мякова [и др.] // Доктор.Ру. Педиатрия. – 2015. – 13 (114): 73–9.
28. Amin A., Burkhart C., Groben P., Morrell D. S. Primary cutaneous T-cell lymphoma following organ transplantation in a 16-year-old boy. Pediatr Dermatol 2009; 26 (1): 112–3.
29. Castano E., Glick S., Wolgast L., Naeem R., Sunkara J., Elston D., Jacobson M. Hypopigmented mycosis fungoides in childhood and adolescence: a long-term retrospective study. J Cutan Pathol 2013; 40 (11): 924–34.
30. Gross A. M., Turner J., Kirkorian A. Y., Okoye G. A., Luca D. C., Bornhorst M., et al. A pediatric case of transformed mycosis fungoides in a BRCA2 positive patient. J Pediatr Hematol Oncol 2020; 42 (5): e361–4.
31. Yang M. Y., Jin H., You H. S., Shim W.-H., Kim J.-M., Kim G.-W., et al. Hypopigmented mycosis fungoides treated with 308 nm excimer laser. Ann Dermatol 2018; 30 (1): 93–5.
32. Ling T. C., Clayton T. H., Crawley J., Exton L. S., Goulden V., Ibbotson S., et al. British Association of Dermatologists and British Photodermatology Group guidelines for the safe and effective use of psoralen–ultraviolet A therapy 2015. Br J Dermatol 2016; 174 (1): 24– 55.
33. Laws P. M., Shear N. H., Pope E. Childhood mycosis fungoides: experience of 28 patients and response to phototherapy. Pediatr Dermatol 2014; 31 (4): 459–64.
34. Trautinger F., Eder J., Assaf C., Bagot M., Cozzio A., Dummer R., et al. European Organisation for Research and Treatment of Cancer consensus recommendations for the treatment of mycosis fungoides / Sézary syndrome – Update 2017. Eur J Cancer 2017; 77: 57–74.
35. Friedland R., David M., Feinmesser M., Barzilai A., Hodak E. NB-UVB (311–312 nm)-induced lentigines in patients with mycosis fungoides: a new adverse effect of phototherapy. J Eur Acad Dermatol 2012; 26 (9): 1158–62.
36. Kalay Y. I., Sanli H., Akay B. N., Sürgün E., Heper A. CD8+ cytotoxic mycosis fungoides: a retrospective analysis of clinical features and follow-up results of 29 patients. Int J Dermatol 2020; 59 (1): 127–33.
37. Amorim G. M., Niemeyer-Corbellini J. P., Quintella D. C., Cuzzi T., Ramos-E-Silva M. Hypopigmented mycosis fungoides: a 20-case retrospective series. Int J Dermatol 2018; 57 (3): 306–12.
38. Oka T., Miyagaki T. Novel and future therapeutic drugs for advanced mycosis fungoides and Sézary syndrome. Front Med 2019; 6: 116.
Pediatric Hematology/Oncology and Immunopathology. 2023; 22: 113-122
Mycosis fungoides in an 11 year-old child: a case report
https://doi.org/10.24287/1726-1708-2023-22-2-113-122Abstract
Primary cutaneous lymphomas are quite rare in children. Clinical and histopathological manifestations of these diseases in children differ significantly from those in adults. Due to their rarity and complex clinical presentation, diagnosis may take long time. Mycosis fungoides (MF) is the most commonly diagnosed form of primary cutaneous lymphomas in childhood. There are no clinical guidelines for the treatment of children. Literature data on MF variants in children are scarce; the largest study includes 34 patients who were diagnosed on average 4 years after the onset of the first symptoms. In the present article we describe a clinical case of MF in an 11-year-old child with an 8-year history of multiple lesions of the skin and scalp. The patient's parents gave their consent to the use of their child's data, including photographs, for research purposes and in publications.
The aim of our article is to demonstrate the problems in the diagnosis of the disease, especially at an early stage, because its symptoms may be similar to those of many common pediatric inflammatory skin conditions.
References
1. Fitzpatrick T. B., Friedberg I. M. Fitzpatrick's Dermatology in General Medicine. 8th ed. New York (NY): MacGraw-Hill; 2008.
2. Jawed S. I., Myskowski P. L., Horwitz S., Moskowitz A., Querfeld C. Primary cutaneous T-cell lymphoma (mycosis fungoides and Cesari syndrome): part I: diagnosis: clinical and histopathological features and new molecular and biological markers. J Am Acad Dermatol 2014; 70 (2): 205. e1-16; quiz 221–2. DOI: 10.1016/j.jaad.2013.07.049
3. Ahn C. S., ALSayyakh A., Sangeza O. P. Mycosis fungoides: an updated review of clinicopathological variants. Am J Dermatopatol 2014; 36 (12): 933–48.
4. Horwitz S. M., Olsen E. A., Duvic M., Porcu P., Kim Y. H. Review of the treatment of mycosis fungoides and Sézary syndrome: a stage-based approach. J Natl Compr Canc Netw 2008; 6 (4): 436–42.
5. Jang M. S., Kang D. Y., Park J. B., Kim J. H., Park K. A., Rim H., et al. Mycosis fungoides resembling lichenoid pityriasis versicolor: clinical and histological features and response to phototherapy. Ann Dermatol 2016; 28: 540–7.
6. Ko J. W., Seong J. Y., Suh K. S., Kim S. T. Pityriasis lichenoides-like mycosis fungoides in children. Br J Dermatol. 2000; 142 (2): 347–52.
7. Fink-Puches R., Chott A., Ardigo M., Simonitsch I., Ferrara G., Kerl H., Cerroni L. The spectrum of cutaneous lymphomas in patients less than 20 years of age. Pediatr Dermatol 2004; 21 (5): 525–53.
8. Ceppi F., Pope E., Ngan B., Abla O. Primary cutaneous lymphomas in children and adolescents. Pediatr Blood Cancer 2016; 63 (11): 1886–94.
9. Ocampo O. V., Julio L., Zapata V., Correa L. A., Vasco C., Correa S., Velásquez-Lopera M. M. Mycosis fungoides in children and adolescents: a series of 23 cases. Actas Dermosifiliogr (Engl Ed) 2020; 111 (2): 149–56.
10. Hodak E., Amitay-Laish I., Feinmesser M., Davidovici B., David M., Zvulunov A., et al. Juvenile mycosis fungoides: cutaneous T-cell lymphoma with frequent follicular involvement. J Am Acad Dermatol 2014; 70 (6): 993– 1001.
11. Boulos S., Vaid R., Aladily T. N., Ivan D. S., Talpur R., Duvic M. Clinical presentation, immunopathology, and treatment of juvenile-on-set mycosis fungoides: a case series of 34 patients. J Am Acad Dermatol 2014; 71 (6): 1117–26.
12. Rodney I. J., Kindred C., Angra K., Qutub O. N., Villanueva A. R., Halder R. M. Hypopigmented mycosis fungoides: a retrospective clinicohistopathologic study. J Eur Acad Dermatol Venereol 2017; 31 (5): 808–14.
13. Fatima S., Siddiqui S., Tariq M. U., Ishtiaque H., Idrees R., Ahmed Z., Ahmed A. Mycosis fungoides: a clinicopathological study of 60 cases from a tertiary care center. Indian J Dermatol 2020; 65 (2): 123–9.
14. Jung J. M., Lim D. J., Won C. H., Chang S. E., Lee M. W., Lee W. J. Mycosis fungoides in children and adolescents: a systematic review. JAMA Dermatol 2021; 157 (4): 431–8.
15. Reiter O., Amitai D. B., Amitay-Laish I., Israeli M., Pavlovsky L., Hodak E. Pediatric mycosis fungoides: a study of the human leukocyte antigen system among Israeli Jewish patients. Arch Dermatol Res 2017; 309 (10): 851–6.
16. Nasimi M., Kamyab K., Aghahi T., Fahim S., Ghandi N. Childhood mycosis fungoides: a clinicopathologic study of 30 cases from Iran. Aust J Dermatol 2020; 61: e259–61.
17. Heng Y. K., Koh M. J. A., Giam Y. C., Tang M. B. Y., Chong W. S., Tan S. H. Pediatric mycosis fungoides in Singapore: a series of 46 children. Pediatr Dermatol 2014; 31 (4): 477–82.
18. Koh M. J.-A., Chong W.-S. Narrow-band ultraviolet B phototherapy for mycosis fungoides in children. Clin Exp Dermatol 2014; 39: 474–8.
19. Alsuwaidan S. N. Childhood mycosis fungoides: new observations from the Middle East. J Saudi Soc Dermatol Dermatol Surg 2012; 16: 5–8.
20. Virmani P., Levin L., Myskowski P. L., Flores E., Marchetti M. A., Skripnik Lucas A., et al. Clinical outcome and prognosis of young patients with mycosis fungoides. Pediatr Dermatol 2017; 34: 547–53.
21. Kim S. T., Sim H. J., Jeon Y. S., Lee J.-W., Roh H.-J., Choi S.-Y., et al. Clinicopathological features and T-cell receptor gene rearrangement findings of mycosis fungoides in patients younger than age 20 years. J Dermatol 2009; 36: 392–402.
22. Nanda A., Al Saleh Q. A., Al-Ajmi H., Al-Sabah H., Elkashlan M., Al-Shemmari S., Demierre M.-F., et al. Mycosis fungoides in Arab children and adolescents: a report of 36 patients from Kuwait. Pediatr Dermatol 2010; 27: 607–13.
23. Wain E. M., Orchard G. E., Whittaker S. J., Spittle M. Sc. M. F., Russell-Jones R. Outcome in 34 patients with juvenile-onset mycosis fungoides: a clinical, immunophenotypic, and molecular study. Cancer 2003; 98 (10): 2282–90.
24. Reiter O., Amitai D. B., Amitay-Laish I., Israeli M., Pavlovsky L., Hodak E. Pediatric mycosis fungoides: a study of the human leukocyte antigen system among Israeli Jewish patients. Arch Dermatol Res 2017; 309 (10): 851–6.
25. Hanna S., Walsh N., D'Intino Y., Langley R. G. B. Mycosis fungoides presenting as pigmented purpuric dermatitis. Pediatr Dermatol 2006; 23: 350–4.
26. Cervini A. B., Torres-Huamani A. N., Sanchez-La-Rosa C., Galluzzo L., Solernou V., Digiorge J., Rubio P. Mycosis fungoides: experience in a pediatric hospital. Actas Dermosifiliográficas (Engl Ed) 2017; 108 (6): 564–70.
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28. Amin A., Burkhart C., Groben P., Morrell D. S. Primary cutaneous T-cell lymphoma following organ transplantation in a 16-year-old boy. Pediatr Dermatol 2009; 26 (1): 112–3.
29. Castano E., Glick S., Wolgast L., Naeem R., Sunkara J., Elston D., Jacobson M. Hypopigmented mycosis fungoides in childhood and adolescence: a long-term retrospective study. J Cutan Pathol 2013; 40 (11): 924–34.
30. Gross A. M., Turner J., Kirkorian A. Y., Okoye G. A., Luca D. C., Bornhorst M., et al. A pediatric case of transformed mycosis fungoides in a BRCA2 positive patient. J Pediatr Hematol Oncol 2020; 42 (5): e361–4.
31. Yang M. Y., Jin H., You H. S., Shim W.-H., Kim J.-M., Kim G.-W., et al. Hypopigmented mycosis fungoides treated with 308 nm excimer laser. Ann Dermatol 2018; 30 (1): 93–5.
32. Ling T. C., Clayton T. H., Crawley J., Exton L. S., Goulden V., Ibbotson S., et al. British Association of Dermatologists and British Photodermatology Group guidelines for the safe and effective use of psoralen–ultraviolet A therapy 2015. Br J Dermatol 2016; 174 (1): 24– 55.
33. Laws P. M., Shear N. H., Pope E. Childhood mycosis fungoides: experience of 28 patients and response to phototherapy. Pediatr Dermatol 2014; 31 (4): 459–64.
34. Trautinger F., Eder J., Assaf C., Bagot M., Cozzio A., Dummer R., et al. European Organisation for Research and Treatment of Cancer consensus recommendations for the treatment of mycosis fungoides / Sézary syndrome – Update 2017. Eur J Cancer 2017; 77: 57–74.
35. Friedland R., David M., Feinmesser M., Barzilai A., Hodak E. NB-UVB (311–312 nm)-induced lentigines in patients with mycosis fungoides: a new adverse effect of phototherapy. J Eur Acad Dermatol 2012; 26 (9): 1158–62.
36. Kalay Y. I., Sanli H., Akay B. N., Sürgün E., Heper A. CD8+ cytotoxic mycosis fungoides: a retrospective analysis of clinical features and follow-up results of 29 patients. Int J Dermatol 2020; 59 (1): 127–33.
37. Amorim G. M., Niemeyer-Corbellini J. P., Quintella D. C., Cuzzi T., Ramos-E-Silva M. Hypopigmented mycosis fungoides: a 20-case retrospective series. Int J Dermatol 2018; 57 (3): 306–12.
38. Oka T., Miyagaki T. Novel and future therapeutic drugs for advanced mycosis fungoides and Sézary syndrome. Front Med 2019; 6: 116.
