Zirbel G M, Gellis S E, Kadin M E, Esterly N B
Department of Dermatology, Medical College of Wisconsin, Milwaukee, USA.
J Am Acad Dermatol. 1995 Nov;33(5 Pt 1):741-8. doi: 10.1016/0190-9622(95)91811-6.
Although lymphomatoid papulosis is well described in adults, the clinical course, prognosis, risk for lymphoma, and recommendations for follow-up have not been established in children.
Our aim was to analyze our data on six children with lymphomatoid papulosis and to analyze available information on reported cases from the literature to characterize better lymphomatoid papulosis in childhood and to compare it with adult-onset lymphomatoid papulosis.
Clinical records, laboratory studies, and histopathologic evaluation of skin biopsy specimens from six children with lymphomatoid papulosis were reviewed. A literature search was also performed and disclosed detailed information on 17 childhood cases.
In most cases childhood lymphomatoid papulosis is clinically and histologically similar to lymphomatoid papulosis in adults, but three unusual patterns were identified in our children: first, after initial outbreak, dwindling outbreaks (both in frequency and number of lesions) until the eruption ceased completely; second, lymphomatoid papulosis localized to one area for years before generalizing, and third, presentation of lymphomatoid papulosis with hundreds of lesions. In our children and in those previously reported, response to systemic antibiotics and potent topical steroids was variable, as in adults. All our children to date have remained healthy; the longest period of follow-up is 9 years. However, in previously reported cases two patients with childhood-onset lymphomatoid papulosis had lymphoma as adults.
Childhood lymphomatoid papulosis may be more likely to resolve spontaneously than adult lymphomatoid papulosis; nevertheless these children may still be at risk for lymphoma and thus need lifelong follow-up.
尽管成人淋巴瘤样丘疹病已有详尽描述，但儿童患者的临床病程、预后、淋巴瘤风险及随访建议尚未明确。
我们旨在分析6例儿童淋巴瘤样丘疹病的资料，并分析文献中报道病例的现有信息，以更好地描述儿童淋巴瘤样丘疹病的特征，并与成人发病的淋巴瘤样丘疹病进行比较。
回顾了6例儿童淋巴瘤样丘疹病患者的临床记录、实验室检查及皮肤活检标本的组织病理学评估。还进行了文献检索，披露了17例儿童病例的详细信息。
在大多数情况下，儿童淋巴瘤样丘疹病在临床和组织学上与成人淋巴瘤样丘疹病相似，但我们的患儿中发现了三种不寻常的模式：第一，初次发作后，发作逐渐减少（发作频率和皮损数量均减少），直至皮疹完全消退；第二，淋巴瘤样丘疹病局限于一个部位数年，之后才泛发；第三，出现数百个皮损的淋巴瘤样丘疹病表现。在我们的患儿及之前报道的患儿中，与成人一样，全身用抗生素和强效外用类固醇的反应各不相同。迄今为止，我们所有的患儿均保持健康；最长随访时间为9年。然而，在之前报道的病例中，两名儿童期发病的淋巴瘤样丘疹病患者成年后发生了淋巴瘤。
儿童淋巴瘤样丘疹病可能比成人淋巴瘤样丘疹病更易自发缓解；尽管如此，这些儿童仍可能有发生淋巴瘤的风险，因此需要终身随访。
