title: Idiopathic CD4 T-Cell Lymphocytopenia: A Case Report of a Young Boy With Recalcitrant Warts.
abstract: OBJECTIVE
  Idiopathic CD4 T-cell lymphocytopenia (ICL) is an immunodeficiency disorder that presents with a decrease in CD4(+) T cells without evidence of a human immunodeficiency virus infection. It is most commonly diagnosed after a patient presents with an opportunistic infection and can also be associated with malignancies and autoimmune diseases. This case presentation and literature review highlights the common skin findings in patients with ICL, mainly recalcitrant warts, and discusses the treatment options available.
  
  
  METHODS
  The patient described is the youngest reported with ICL presenting with isolated cutaneous findings of recalcitrant warts and psoriasis. Many treatment options were tried for the warts, with the most significant response to acitretin.
  
  
  CONCLUSIONS
  This case highlights the importance of considering underlying immunodeficiency in patients with recalcitrant warts as well as developing treatment plans. Such patients require close follow-up by both dermatology and immunology to monitor for the development of other diseases related to ICL.
authors.affiliation: Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Loretta
authors.initials: L
authors.lastname: Cheung
authors.affiliation: Division of Paediatric Medicine, Section of Dermatology, Hospital for Sick Children, Toronto, ON, Canada miriam.weinstein@sickkids.ca.
authors.forename: Miriam
authors.initials: M
authors.lastname: Weinstein
mesh_terms: D017255:Acitretin / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002648:Child; D017679:Cryotherapy; D003879:Dermatologic Agents / Q000627:therapeutic use*; D006801:Humans; D007641:Keratolytic Agents / Q000627:therapeutic use; D008231:Lymphopenia / Q000097:blood / Q000150:complications*; D008297:Male; D011565:Psoriasis / Q000150:complications / Q000188:drug therapy*; D019233:Retreatment; D014860:Warts / Q000150:complications / Q000628:therapy*
chemical_list: D003879:Dermatologic Agents; D007641:Keratolytic Agents; D017255:Acitretin
keywords: CD4; idiopathic; lymphocytopenia; pediatric; recalcitrant; warts