Clinical Analysis And Literature Review Of 5 Cases Of Children's Hypopigmented Mycosis Fungoides

Objective: Analysis of the clinical data of hypopigmented mycosis fungoides in children including Dermoscopy,histopathology,Assessment of visceral organs,treatment and follow-up.To enhance the understanding of HMF and to improve the level of diagnosis and treatment at the early stage of HMF.Methods: The clinical data of 5 patients with HMF admitted from January 2016 to September 2017 were retrospectively analyzed and followed up with literature review.Results: All 5 cases were male,the age of onset was 2-9 years,the average age of onset was 5.6 years old,the age of diagnosis was 4-11.6 years,and the average age of diagnosis was 8 years.All had been misdiagnosed as vitiligo,pityriasis alba,chronic pityriasis lichenoides,post-inflammatory hypopigmentation.All of the 5 cases were in stage IB,only hypopigmented skin lesions,without conscious symptoms.Three cases had superficial lymphadenopathy and abnormal electrocardiogram,no other organs were involved.The dermoscopic examination showed areas of orange-yellow patches,unstructured areas with wave-like,grid-like hypopigmentation,punctate,short,thin,linear blood vessels and sperm-like structures.Histopathology revealed that the nucleus of the lymphocytes were large and darkly stained with halo around them and showed abnormality.Lymphocytes are linearly arranged at the junction of the dermal epidermis and are significantly epidermotropism but not with sponge edema.Of the 5 patients,4 were treated with NB-UVB and 1 was treated with external medication,all were effective.Conclusion: HMF is rare,male and children are Prefer to be involved,which is easily misdiagnosed and missed and need to be identified with a variety of dermatoses associated with pigmentation.The characteristics of dermoscopy can provide a reference for the necessity of biopsy and assessment of the condition.Histopathology and immunohistochemistry can establish the diagnosis.Although HMF is an inert tumor,systematic evaluation and long-term follow-up are still necessary.NB-UVB treatment of children with HMF is well tolerated and has a good effect on improving skin damage.Long-term follow-up is still needed to assess prognosis.