title: A patient with elderly-onset atypical hydroa vacciniforme with an indolent clinical course.
abstract: Hydroa vacciniforme (HV) is a rare photodermatosis that mainly affects children and manifests as vesiculopapular eruptions in sun-exposed areas without systemic symptoms. HV-like lymphoma (HVLL) is one of the Epstein-Barr virus (EBV)-associated lymphoproliferative disorders (LPD) of childhood. Its diagnosis is based on monoclonal T-cell proliferation; however, its degree of malignancy is controversial owing to its variable prognosis. Elderly-onset cases of these diseases are extremely rare, and the clinical features remain unknown. It has been shown that late onset is closely associated with a severe phenotype in EBV-associated LPD including atypical HV. Here we describe a case of elderly-onset atypical HV accompanied by T-cell monoclonality, but with a very indolent clinical course. Our patient indicates a possible case with elderly-onset atypical HV manifesting a favourable course, and that T-cell monoclonality and age of onset cannot always predict the disease severity, and highlights the difficulty of prognosis prediction in elderly-onset atypical HV.
authors.affiliation: Department of Dermatology, Shizuoka Municipal Shimizu Hospital, 1231 Miyakami, Shimizu-ku Shizuoka City, Shizuoka, 424-0911, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Nomura
authors.affiliation: Department of Dermatology, Shizuoka Municipal Shizuoka Hospital, Shizuoka, JShizuoka.
authors.forename: H
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Dermatology, Shizuoka Municipal Shimizu Hospital, 1231 Miyakami, Shimizu-ku Shizuoka City, Shizuoka, 424-0911, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Egami
authors.affiliation: Department of Dermatology, Shizuoka Municipal Shimizu Hospital, 1231 Miyakami, Shimizu-ku Shizuoka City, Shizuoka, 424-0911, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yokoyama
authors.affiliation: Department of Dermatology, Shizuoka Municipal Shimizu Hospital, 1231 Miyakami, Shimizu-ku Shizuoka City, Shizuoka, 424-0911, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Sugiura
authors.affiliation: Department of Dermatology, Shizuoka Municipal Shizuoka Hospital, Shizuoka, JShizuoka.
authors.forename: K
authors.initials: K
authors.lastname: Tomita
authors.affiliation: Department of Laboratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Imada
authors.affiliation: Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Taniguchi
authors.affiliation: Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yoshino
authors.affiliation: Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Iwatsuki
mesh_terms: D000368:Aged; D005148:Facial Dermatoses / Q000276:immunology*; D005260:Female; D004854:Herpesvirus 4, Human / Q000276:immunology; D006801:Humans; D006837:Hydroa Vacciniforme / Q000276:immunology*; D000067562:Late Onset Disorders; D013601:T-Lymphocytes / Q000276:immunology