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Correspondence |

Rapid Cutaneous Dissemination of Persistently Agminated Lymphomatoid Papulosis in a 9-Year-Old Boy

Derek V. Chan, MD, PhD; Jonathan Staidle, BS; Joan Tamburro, DO; Eliot Mostow, MD, MPH
Arch Dermatol. 2011;147(11):1340-1342. doi:10.1001/archdermatol.2011.348.
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Although “localized ” or “regional ” eruptions of lymphomatoid papulosis (LyP) have been reported in the literature, specific references to distinct grouped lesions in a circumscribed patch have been reported in the context of persistent agminated lymphomatoid papulosis (PALP).14 It has been suggested that an “agminated CD30+ lymphoproliferative disorder  .  .  .  be considered a lymphoma, ”1(p1011) owing in part to the potential for disease progression to mycosis fungoides –like patches if untreated, and that PALP be treated aggressively with ablation therapy, specifically radiation therapy.1 Of the 9 reported cases of PALP that we found in the literature,14 only 1 case, in a 27-year-old man, evolved to disseminated classic LyP.2 We report herein a case of steroid-responsive agminated LyP in a pediatric patient that quickly evolved to disseminated disease, thus providing further evidence to support aggressive treatment of agminated LyP.

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Figure 1. Agminated papulonodules with crusting and ulceration are seen on the patient's right upper chest with additional secondary lesions outside the agminated patch.

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Figure 2. Evolution of the initial agminated papulonodules to generalized lesions on the back of the patient.

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