Paul M A, Krowchuk D P, Hitchcock M G, Jorizzo J L
Department of Dermatology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA.
Pediatr Dermatol. 1996 Nov-Dec;13(6):501-6. doi: 10.1111/j.1525-1470.1996.tb00734.x.
Lymphomatoid papulosis is a T-cell proliferation that occurs primarily in adults but has been well described in children. Lesions may regress spontaneously but often leave residual scarring and, as a result, intervention frequently is considered. Therapeutic modalities commonly employed for adults with lymphomatoid papulosis may be poorly tolerated by pediatric patients. We present a series of three children with lymphomatoid papulosis treated with superpotent topical corticosteroids (halobetasol or clobetasol propionate). When applied twice daily for 2 to 3 weeks followed by weekly pulsed application, this treatment resulted in complete resolution of nearly all cutaneous lesions. Three ulcerated lesions, occurring in two patients, required adjuvant therapy with intralesional triamcinolone. To date one patient remains free of cutaneous disease and two children experience occasional new lesions that respond to renewed treatment with topical clobetasol propionate. None of the children have evidence of systemic disease. We conclude that pulsed application of a superpotent topical corticosteroid is efficacious and safe in the management of cutaneous lesions of lymphomatoid papulosis and avoids the risks often associated with more aggressive interventions. Since these agents do not alter the risk of subsequent malignancy, careful ongoing surveillance of children with lymphomatoid papulosis is imperative.
淋巴瘤样丘疹病是一种主要发生于成人的T细胞增殖性疾病，但在儿童中也有详细描述。皮损可自发消退，但常遗留瘢痕，因此常需进行干预。成人淋巴瘤样丘疹病常用的治疗方法儿科患者可能耐受性较差。我们报告了3例接受超强效外用糖皮质激素（卤米松或丙酸氯倍他索）治疗的淋巴瘤样丘疹病患儿。每日外用2次，持续2至3周，随后每周脉冲式外用，该治疗使几乎所有皮肤损害完全消退。2例患者出现的3处溃疡皮损需要皮损内注射曲安奈德辅助治疗。迄今为止，1例患者皮肤疾病已痊愈，2例患儿偶尔出现新皮损，外用丙酸氯倍他索重新治疗有效。所有患儿均无系统性疾病证据。我们得出结论，超强效外用糖皮质激素脉冲式外用治疗淋巴瘤样丘疹病的皮肤损害有效且安全，可避免与更积极干预相关的风险。由于这些药物不会改变后续发生恶性肿瘤的风险，因此对淋巴瘤样丘疹病患儿进行仔细的持续监测至关重要。
