Pityriasis lichenoides in childhood: A retrospective review of 124 patients

• Published in: Journal of the American Academy of Dermatology 2007-02, Vol.56 (2), p.205-210
• Main Authors: Ersoy-Evans, Sibel, MD, Greco, M. Fernanda, MD, Mancini, Anthony J., MD, Subaş, Nuket, MD, Paller, Amy S., MD
• Format: Article
• Language: English
• Subjects: Adolescent; Age Distribution; Age of Onset; Biological and medical sciences; Child; Child, Preschool; Comorbidity; Dermatology; Female; General aspects; Humans; Infant; Male; Medical sciences; Pityriasis Lichenoides - diagnosis; Pityriasis Lichenoides - epidemiology; Psoriasis. Parapsoriasis. Lichen; Retrospective Studies; Seasons
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2006.08.023

Background Pityriasis lichenoides (PL) occurs in all age groups, although predominantly in younger individuals. Objective We sought to study the clinical features of PL in children followed up at our institution. Methods The records of 124 children who were given the diagnosis of PL at our institution between 1993 and 2003 were retrospectively reviewed. Results PL chronica (PLC) was recorded in 37% of the cases, PL et varioliformis acuta (PLEVA) in 57.3%, and clinical features of both disorders were seen simultaneously in the remaining. The median age of onset was 60 months (range: 6-180 months), although the median age of onset of PLEVA (median: 60 months) was significantly younger than that of PLC (median: 72 months) ( P = .03). The age distribution showed peaks at 2 to 3 years (24.8%) and 5 to 7 years (32%). A history of infection or drug intake preceded the skin manifestations in 30% and 11.2% of patients with PLC and PLEVA, respectively. The disease began most commonly during winter (35%) or fall (30%). The median duration was 20 months (range: 3-132 months) in patients with PLC and 18 months (range: 4-108 months) in patients with PLEVA. Involvement was diffuse in 74.2% of the patients, peripheral in 20.2%, and central in the remainder. The disease was recurrent in 77% of the patients (n = 80). Of the patients, 59% had pruritus, whereas 32% reported no symptoms; the remainder had fever, arthralgia, or both. Erythromycin estolate or ethylsuccinate was administered to 79.7% of the affected children; 66.6% of these showed at least a partial response. Limitations The analyzed data were collected retrospectively and biopsies were not performed in all patients. Conclusions PL is not an uncommon disease in childhood, with age peaks in the preschool and early school-age years. It is usually recurrent, and shows a seasonal variation with onset most often in the fall or winter. In childhood PL, erythromycin is an effective initial treatment choice.