Pediatric primary cutaneous anaplastic large-cell lymphoma with associated hypovitaminosis D

CD30+ lymphoproliferative diseases (LPDs) are relatively uncommon in the general population, especially in children. Distinguishing between the two main CD30+ LPDs, lymphomatoid papulosis and cutaneous anaplastic large-cell lymphoma is crucial, as the latter requires different treatment and systemic malignancy workup. We outline an uncommon presentation of a primary cutaneous anaplastic large-cell lymphoma (PC-ALCL) accompanied by hypovitaminosis D in a young Hispanic child and a holistic approach to treatment. While baseline testing of vitamin D levels in patients with cutaneous lymphoma and LPDs is not yet the standard in dermatology, it is being increasingly performed by other specialties who care for solid tumor and hematologic malignancies, since low levels can portend poorer prognosis and outcomes. Although there are no precise treatment guidelines for pediatric PC-ALCL located in cosmetically sensitive areas, a minimally invasive therapeutic program comprised of shave removal, topical steroids, and correction of a potentially disease modifying comorbidity (hypovitaminosis D if present) offers a comprehensive approach.