Cutaneous Hematologic Neoplasms in Children: Overview and Update

Area of Science:

• Dermatology
• Pediatric Hematology/Oncology
• Pathology

Background:

• Cutaneous hematologic neoplasms in children are uncommon, presenting diverse lymphoproliferative and myeloproliferative disorders.
• Key entities include lymphomatoid papulosis (LyP) and mycosis fungoides (MF), often requiring differentiation from benign conditions like pityriasis lichenoides.

Purpose of the Study:

• To review and update the classification, clinical presentation, diagnosis, histopathology, and management of pediatric cutaneous lymphomas, lymphoproliferations, and leukemias.
• To highlight the indolent nature of most pediatric cutaneous lymphoproliferations while emphasizing the importance of identifying rarer aggressive malignancies.

Main Methods:

• Comprehensive literature review focusing on classification, clinical features, diagnostic challenges, histopathology, and management strategies.
• Emphasis on clinical-pathological correlation and the role of clonality studies in diagnosis.

Main Results:

• Most pediatric cutaneous lymphoproliferations, such as primary cutaneous CD4+ small/medium T-cell disorder and EBV-related disorders, are indolent.
• Aggressive conditions like certain leukemias and blastic plasmacytoid dendritic cell neoplasm, though rarer, must be recognized.

Conclusions:

• Accurate diagnosis of pediatric cutaneous hematologic neoplasms relies on clinical-pathological correlation and ancillary studies.
• Management ranges from skin-directed therapies for indolent forms to systemic treatments for aggressive leukemias and lymphomas.