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Welfringer-Morin A, Barroil M, Fraitag S, Szablewski V, Boccara O, Lacour JP, Chiaverini C, Bagot M, Ram-Wolff C, Vignon-Pennamen MD, Dalle S, D'incan M, Amatore F, Beylot-Barry M, Vergier B, Mazereeuw-Hautier J, Tedbirt B, Quereux G, Carpentier O, Skowron F, Bertrand Y, Van Eeckhout P, Dekeuleneer V, Nardin C, Adamski H, Ingen-Housz-Oro S, Dereure O, Bodemer C. Clinical Features, Histological Characteristics, and Disease Outcomes of Mycosis Fungoides in Children and Adolescents: A Nationwide Multicentre Cohort of 46 Patients. Dermatology 2022; 239:132-139. [PMID: 36349768 DOI: 10.1159/000526788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/21/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Our objective was to describe the clinical, histological characteristics, and disease outcome of a cohort of mycosis fungoides (MF) diagnosed during childhood including disease status at adulthood. METHODS This is a retrospective multicentre survey of patients aged under 18 years at diagnosis with histologically confirmed MF. Patients' clinical and histological characteristics, treatments, and disease outcome (for patients followed for more than 12 months) were analysed. RESULTS Forty-six patients were included (median age at diagnosis: 11 years; M:F sex ratio: 3:1) with 39 (85%) followed for at least 12 months. Thirty-nine patients (85%) had stage I MF. Hypopigmented patches were observed in 48% and folliculotropism in 43% patients. Immunophenotype of the skin infiltrate was predominantly CD8+ in 17% of patients. Initial management included a wait-and-see strategy in 6/39 (15%), skin-directed treatment in 27 (69%), and systemic treatment in 6 (15%) patients, respectively, with partial or complete clinical response (PR or CR) observed in 28 patients (72%). 14/39 patients (36%) relapsed after initial response. After a median follow-up period of 54 months, disease status at last news was PR or CR in 31/39 (79%), stable disease in 6 (15%), and progression in 2 (5%) patients. Histological transformation was observed in 3/39 (8%). Of the 15 patients followed until adulthood, 13 (87%) had persistent MF. DISCUSSION This survey confirms the high frequency of hypopigmented and folliculotropic lesions and of CD8+ immunophenotype compared to adult MF patients. The long-term course is usually indolent but transformation may occur sometimes long after disease onset and the disease may persist during adulthood.
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Affiliation(s)
- Anne Welfringer-Morin
- Department of Dermatology, Hospital Necker-Enfants Malades, APHP. Centre-Université de Paris, Paris, France,
| | - Marion Barroil
- Department of Dermatology, University of Montpellier and INSERM U1058, Montpellier, France
| | - Sylvie Fraitag
- Department of Pathology, Hospital Necker-Enfants Malades, APHP. Centre-Université de Paris, Paris, France
| | | | - Olivia Boccara
- Department of Dermatology, Hospital Necker-Enfants Malades, APHP. Centre-Université de Paris, Paris, France
| | - Jean-Philippe Lacour
- Department of Dermatology, CHU de Nice, Université Nice Côte d'Azur, Nice, France
| | - Christine Chiaverini
- Department of Dermatology, CHU de Nice, Université Nice Côte d'Azur, Nice, France
| | - Martine Bagot
- Department of Dermatology, Hospital Saint Louis, APHP. Université de Paris, INSERM UMR 976, Paris, France
| | - Caroline Ram-Wolff
- Department of Dermatology, Hospital Saint Louis, APHP. Université de Paris, INSERM UMR 976, Paris, France
| | | | - Stéphane Dalle
- Department of Dermatology, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre Bénite, France
| | - Michel D'incan
- Department of Dermatology, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Florent Amatore
- Department of Dermatology, Hospital la Timone, Université Aix-Marseille, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | - Marie Beylot-Barry
- Department of Dermatology, CHU de Bordeaux, INSERM U1053 Oncogenèse des lymphomes cutanés, Université de Bordeaux, Bordeaux, France
| | - Béatrice Vergier
- Department of Pathology, CHU de Bordeaux, INSERM U1053 Oncogenèse des lymphomes cutanés, Université de Bordeaux, Bordeaux, France
| | | | | | - Gaelle Quereux
- Department of Dermatology, Hotel Dieu, CHU de Nantes, Nantes, France
| | - Olivier Carpentier
- Department of Dermatology, Hospital Claude Huriez, CHRU Lille, Lille, France
| | | | - Yves Bertrand
- Department of Hematology, Institut d'hématologie et oncologie pediatrique, Lyon, France
| | - Pascal Van Eeckhout
- Department of Pathology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Valérie Dekeuleneer
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Charlee Nardin
- Department of Dermatology, CHU de Besancon, INSERM UMR 1098, Université de Franche-Comté, Besancon, France
| | - Henri Adamski
- Department of Dermatology, CHU Pontchaillou, Rennes, France
| | - Saskia Ingen-Housz-Oro
- Department of Dermatology, Hospital Henri Mondor, APHP, University Paris Est Créteil EpiDermE, Creteil, France
| | - Olivier Dereure
- Department of Dermatology, University of Montpellier and INSERM U1058, Montpellier, France
| | - Christine Bodemer
- Department of Dermatology, Hospital Necker-Enfants Malades, APHP. Centre-Université de Paris, Paris, France
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