LYMPHOMATOID PAPULOSIS - SUCCESSFUL WEEKLY PULSE SUPERPOTENT TOPICAL CORTICOSTEROID-THERAPY IN 3 PEDIATRIC-PATIENTS

Lymphomatoid papulosis is a T-cell proliferation that occurs primarily in adults but has been well described in children. Lesions may regres s spontaneously but often leave residual scarring and, as a result, in tervention frequently is considered. Therapeutic modalities commonly e mployed for adults with lymphomatoid papulosis may be poorly tolerated by pediatric patients. We present a series of three children with lym phomatoid papulosis treated with superpotent topical corticosteroids ( halobetasol or clobetasol propionate). When applied twice daily for 2 to 3 weeks followed by weekly pulsed application, this treatment resul ted in complete resolution of nearly ail cutaneous lesions. Three ulce rated lesions, occurring in two patients, required adjuvant therapy wi th intralesional triamcinolone. To date one patient remains free of cu taneous disease and two children experience occasional new lesions tha t respond to renewed treatment with topical clobetasol propionate. Non e of the children have evidence of systemic disease. We conclude that pulsed application of a superpotent topical corticosteroid is efficaci ous and safe in the management of cutaneous lesions of lymphomatoid pa pulosis and avoids the risks often associated with more aggressive int erventions. Since these agents do not alter the risk of subsequent mal ignancy, careful ongoing surveillance of children with lymphomatoid pa pulosis is imperative.