Treatment of childhood mycosis fungoides with narrow-band phototherapy.

46 Correspondence Treatment of childhood mycosis fungoides with narrow-band phototherapy Mycosis fungoides (MF) is a form of cutaneous T-cell lymphoma, usually arising in mid to late adulthood. 1 It is rarely described in children. 2,3 The most common presentation of MF diagnosed during childhood and adolescence is limited or generalized patch-stage disease without lymph node enlargement or with histologically negative nodes. 3,4 Herein, we present a patch-stage MF case in a Turkish girl who was treated successfully with narrow-band phototherapy. A 4-year-old girl is presented with disseminated asymptomatic hyperpigmented macules on her trunk. The lesions were first identified at the age of 18 months and further developed despite treatment with topical corticosteroids. Upon physical examination, she had erythematous, slightly scaly, irregularly bordered macules and patches of size 2–10 cm in diameter on her abdomen, flank, and left thigh. Sensation was normal and the lesions were not palpable (Figs 1 and 2). The result of a potassium hydroxide examination of the scale was negative. The histopathologic examination results revealed lymphocytes with darkly stained nuclei, either single or grouped, with extension along the dermo-epidermal junction and a bandlike infiltrate of large lymphocytes in papillary dermis (Fig. 3). Systemic examination and laboratory findings were found to be normal. Neither lymphadenopathy nor organomegaly were detected on clinical examination. According to the TNM (tumor, node, metastases) classification, the patient was in stage 1A (patch/plaques < 10% body surface area with no palpable lymph nodes). She received narrowband ultraviolet B (UVB) three times a week and had clinical and histological remission after a total of 30 sessions (total = 27 J/cm 2 ) over 2.5 months. She was then maintained on a regimen of once weekly for 5 months.