Clinical, histopathologic, and immunophenotypic features of lymphomatoid papulosis with CD8 predominance in 14 pediatric patients.
BACKGROUND
Lymphomatoid papulosis (LyP) is a cyclic papulonodular eruption that is clinically benign and histologically malignant. Association with hematologic neoplasias has been reported in 5% to 20% of all cases.


OBJECTIVE
We sought to review the clinical and histopathologic features of LyP in pediatric patients.


METHODS
We searched for the records of all patients with a clinical and histopathologic diagnosis of LyP seen at our clinic from January 1991 through April 2008. The cases of pediatric patients (aged < 20 years) were reviewed in detail.


RESULTS
Of 123 patients with LyP identified, 14 (11%) were in the pediatric age group. Most were male (64%); mean age of onset was 12 years. Type A LyP was identified in 12 patients, one patient had type B, and none had type C (type not determined in one case). Ten cases showed CD8 predominance by immunohistochemistry. T-cell intracytoplasmic antigen staining was positive in 3 cases of CD8(+) LyP type A and the one case of LyP type B. Lesional T-cell receptor gene rearrangement studies were negative in 9 of 10 patients with LyP type A. The average follow-up time was 5.5 years. Lesions improved with treatment in most cases, and none of the cases were associated with hematologic malignancies.


CONCLUSIONS
This was a retrospective review.


CONCLUSIONS
Among our pediatric patients, we noted a predominance of CD8(+) LyP, which does not seem to have an aggressive course. Further longitudinal studies are necessary to evaluate prognostic differences between CD4(+) and CD8(+) LyP and their biological significance.
de Souza
Aieska
A
Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA.
Camilleri
Michael J
MJ
Wada
David A
DA
Appert
David L
DL
Gibson
Lawrence E
LE
el-Azhary
Rokea A
RA
D000293:Adolescent; D016827:CD8 Antigens / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D005260:Female; D015329:Gene Rearrangement, T-Lymphocyte; D006801:Humans; D016130:Immunophenotyping; D007223:Infant; D017731:Lymphomatoid Papulosis / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D008297:Male; D012878:Skin Neoplasms / Q000235:genetics / Q000276:immunology / Q000473:pathology*
D016827:CD8 Antigens