Atypical pediatric presentation of lymphocytic thrombophilic arteritis: Diagnostic difficulties and recent nosological clarification

Pediatr Dermatol. 2021 Jan;38(1):304-305. doi: 10.1111/pde.14412. Epub 2020 Oct 21.

Abstract

A 4-year-old girl presented with a 2-month history of round, hypopigmented, slightly scaly patches measuring 1-6 cm and encircled by an erythematous halo, first appearing on the lower limbs then spreading to the whole body. Three biopsies were taken as the condition progressed, each showing a lymphocytic infiltrate affecting a medium-sized artery at the dermal-subcutaneous junction, with a concentric fibrin ring. These findings are characteristic of lymphocytic thrombophilic arteritis (LTA). The young age of our patient and the type of skin lesions she developed make this an atypical presentation of LTA, which usually manifests as hyperpigmented macules on the lower extremities, predominantly in dark-skinned women.

Keywords: lymphocytic thrombophilic arteritis; macular arteritis; pediatrics; polyarteritis nodosa; vasculitis.

Publication types

  • Case Reports

MeSH terms

  • Arteritis* / diagnosis
  • Biopsy
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Hyperpigmentation*
  • Lymphocytes
  • Polyarteritis Nodosa*
  • Skin