Tan E, Tay Y K, Giam Y C
National Skin Centre, Singapore.
Pediatr Dermatol. 2000 Sep-Oct;17(5):352-6. doi: 10.1046/j.1525-1470.2000.017005352.x.
Mycosis fungoides (MF) is the most common form of cutaneous T-cell lymphoma. It usually occurs in middle-aged and elderly persons, although several reports have described its occurrence in young children. The aim of this study was to review the profile and outcome of childhood MF in Singapore from 1989 to 1998. A total of nine patients (six males and three females) were diagnosed with MF before the age of 21 years. There were four Chinese, four Malay, and one Indian. The age at the time of histologic diagnosis ranged from 6 to 20 years (mean 14.3 years). Eight of the nine patients presented with hypopigmented patches and plaques. According to TNM staging, three were in stage 1A and six in stage 1B. The treatment modalities included psoralen plus ultraviolet A (PUVA) (n = 5), UVB (n = 2), and potent topical steroids (n = 2). We found that PUVA induced a faster clinical remission, but maintenance PUVA was required to prolong the relapse-free interval. This study also highlighted the need to consider MF in the differential diagnosis of hypopigmented dermatoses in dark-skinned individuals, especially if they occur on the buttocks.
蕈样肉芽肿(MF)是皮肤T细胞淋巴瘤最常见的形式。它通常发生在中老年人中,不过有几份报告描述了其在幼儿中的发生情况。本研究的目的是回顾1989年至1998年新加坡儿童MF的概况和结局。共有9名患者(6名男性和3名女性)在21岁之前被诊断为MF。其中有4名华人、4名马来人和1名印度人。组织学诊断时的年龄范围为6至20岁(平均14.3岁)。9名患者中有8名表现为色素减退斑和斑块。根据TNM分期,3例为1A期,6例为1B期。治疗方式包括补骨脂素加紫外线A(PUVA)(n = 5)、紫外线B(UVB)(n = 2)和强效外用类固醇(n = 2)。我们发现PUVA可诱导更快的临床缓解,但需要维持PUVA以延长无复发间隔。这项研究还强调,在深色皮肤个体色素减退性皮肤病的鉴别诊断中需要考虑MF,尤其是如果病变发生在臀部。