Solitary plaque on the leg of a child: A report of two cases and a brief review of acral pseudolymphomatous angiokeratoma of children and unilesional mycosis fungoides

Abstract

Acral pseudolymphomatous angiokeratoma of children (APACHE) and unilesional mycosis fungoides (MF) are two rare dermatoses in the pediatric population which may have overlapping clinical and histopathologic features, making differentiation between these two diagnoses difficult. We present two similar cases of a solitary plaque on the thigh of a child, one representing APACHE and the other representing unilesional MF with granulomatous features, and we provide a brief overview of the clinical and histopathologic features of APACHE and unilesional MF.

Mycosis fungoides in pediatric patients: Clinical features, diagnostic challenges, and advances in therapeutic management

“…Although rare, several case reports have emerged describing unilesional MF in children. Unilesional MF is typically characterized by a single erythematous patch or plaque with overlying scale . The lesion typically arises on non–sun‐exposed skin and is often present for several years prior to diagnosis …”

“…Unilesional MF is typically characterized by a single erythematous patch or plaque with overlying scale. 29 The lesion typically arises on non-sun-exposed skin and is often present for several years prior to diagnosis. 29,30…”

“…29 The lesion typically arises on non-sun-exposed skin and is often present for several years prior to diagnosis. 29,30…”

Pseudomalignancies in Children: Histological Clues, and Pitfalls to Be Avoided

“…To the best of our knowledge, the presence or absence of CD30 in APACHE has not been studied immunohistochemically. A PCR analysis reveals that APACHE is a polyclonal disorder [25,26].…”

A Comprehensive Update of the Atypical, Rare and Mimicking Presentations of Mycosis Fungoides

“…The annual incidence varies between 0.3 and 0.96 cases per 100,000 persons [9], typically affecting patients between 45 and 65 years of age, with a male to female sex ratio of 2:1. Childhood and adolescent MF cases are more exceptional [10][11][12][13][14][15][16].…”