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Chapter 8
Children and Young Adults with
Cutaneous Lymphoma
Cutaneous lymphoma is a rare disease in general. It is even rarer to find
it in children. In Europe and the United States, up to 5% of all cases are
diagnosed before the age of 20. However, in some parts of the world, such
as the Arab populations in the Middle East, children constitute up to 60% of
the patients with mycosis fungoides. Prevalence rates differ greatly among
geographic regions and populations.
Many researchers believe that mycosis fungoides, in young people in
particular, may have a genetic component and may be triggered by
environmental factors. In fact, there may be a link between skin type
and early incidence of this disease. For example, African Americans are
diagnosed with mycosis fungoides before the age of 40 significantly more
often than Caucasians.
Despite the infrequent occurrence of this disease in children, the principles
of diagnosis remain the same regardless of age. However, there are some
special considerations regarding this age group. For example, physicians
devote extra attention to determining a course of treatment for younger
patients, weighing the benefit of therapy against any potentially long-term
complications more prevalent among the pediatric age group than adults.
Phototherapy is the preferred treatment for mycosis fungoides, but if a child
is very young, they are technically unsuitable for it.
Among children, the distinguishing features of this disease can be
misleading, making it ever more difficult to diagnose cutaneous lymphoma
in children. Another complicating factor is that the medical community
is usually hesitant to perform biopsies on children unless there is absolute
indication of the presence of this disease – and biopsy is the best way to
firmly diagnose cutaneous lymphoma. For these reasons, diagnosis in
children is often delayed much longer than in adults. The prognosis for
children is similar to adults.
When children have chronic inflammatory dermatitis, which are ongoing
skin conditions that are not classified with a certain diagnosis (an unusual
2
Treating Cutaneous Lymphoma
