Eur J Dermatol. 2024 Apr 1;34(2):144-149. doi: 10.1684/ejd.2024.4648.
Hydroa vacciniforme lymphoproliferative disorder (HVLPD) is a rare disease related to Epstein-Barr virus (EBV), mainly in children, and is an EBV-associated cutaneous T and natural killer (NK) cell lymphoproliferative disorder. The disorder in some patients may progress to EBV-associated systemic T or NK-cell lymphoma. To summarize the characteristics of HVLPD in Chinese paediatric patients and to examine the risk factors indicating poor prognosis. We performed a retrospective analysis of patients with HVLPD from the Department of Dermatology, Beijing Children's Hospital. Based on diagnosis, medical history, examination results, and immunophenotype, we analysed HVLPD in 42 paediatric cases in order to examine the clinical features, prognoses, and risk factors. Forty-two paediatric patients were enrolled, with a median onset age of five years. All patients presented with papulovesicular lesions, and 32 systemic HVLPD (sHVLPD) patients had systemic symptoms, including fever, lymphadenopathy, hepatomegaly, splenomegaly, and liver dysfunction. Of the sHVLPD cases, 13 also had severe mosquito bite allergy (SMBA). Twenty-five cases were T-type, and nine were CD56+-dominant type. Follow-up data showed that 12 patients had complete remission, and three patients died. SMBA is a risk factor for disease progression in patients with HVLPD, and the pathological CD56+-dominant phenotype is associated with poor prognosis.
水疱疹样淋巴组织增生异常(HVLPD)是一种与 EBV 相关的罕见疾病,主要发生于儿童,是一种 EBV 相关的皮肤 T 细胞和自然杀伤(NK)细胞淋巴组织增生异常。该疾病在一些患者中可能进展为 EBV 相关的系统性 T 细胞或 NK 细胞淋巴瘤。为总结中国儿科 HVLPD 患者的特点,探讨提示不良预后的危险因素。我们对北京儿童医院皮肤科收治的 HVLPD 患者进行了回顾性分析。根据诊断、病史、检查结果和免疫表型,我们分析了 42 例儿科 HVLPD 患者,以探讨其临床特征、预后和危险因素。共纳入 42 例儿科患者,中位发病年龄为 5 岁。所有患者均表现为丘疹水疱性皮损,32 例系统性 HVLPD(sHVLPD)患者存在全身症状,包括发热、淋巴结肿大、肝脾肿大和肝功能异常。其中 13 例 sHVLPD 患者还伴有严重蚊虫叮咬过敏(SMBA)。25 例为 T 细胞型,9 例为 CD56+主导型。随访数据显示,12 例患者完全缓解,3 例患者死亡。SMBA 是 HVLPD 患者疾病进展的危险因素,病理 CD56+主导型与不良预后相关。