A rare case of Pediatric Mycosis Fungoides presenting as Benign Dermatoses

Primary cutaneous lymphomas (PCL) encompass a range of cutaneous T cell and B cell lymphomas. Mycosis fungoides (MF), a rare form of cutaneous T cell lymphoma, predominantly affects adults, with very few cases reported in children. In pediatric patients, MF often presents as hypopigmented patches that can be mistaken for benign skin conditions, complicating diagnosis. This report details a case of pediatric MF in a 7-year-old boy.

The boy presented with worsening skin lesions, initially appearing as erythematous, papular rashes on the face and upper limbs, which eventually spread across his body, becoming hypopigmented and accompanied by itching and scaling over the course of a year. Despite multiple treatments for eczema and pityriasis alba, including various topical steroids and emollients, he showed little improvement. Due to the persistent nature of his symptoms, he was referred to a dermatology clinic where two skin biopsies were conducted. The first biopsy indicated epidermotropism of atypical lymphocytes, suggesting MF. Immunohistochemical analysis showed positive CD3+ expression, with reduced levels of CD4+, CD7+, and CD8+, while CD2+ and CD5+ expressions were normal. Given the rarity of MF in children, a second biopsy was performed, confirming the diagnosis.

To conclude, pediatric MF is an uncommon and difficult diagnosis. This case underscores the need for careful monitoring of unresolved hypopigmented lesions and heightened awareness for lesions that do not respond to standard treatments. Early diagnosis supported by skin biopsy is essential to prevent serious disease progression and to facilitate appropriate management, ultimately leading to better patient outcomes.

Source: Rosli S, Abd Halim H, Md-Yasin M, Abu Bakar NA. Pediatric Mycosis Fungoides Mimicking Benign Dermatoses: A Report of a Rare Case. Am J Case Rep. 2025 Jan 7;26:e945897. doi: 10.12659/AJCR.945897. PMID: 39774580; PMCID: PMC11725661.

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