A giant variant of acquired reactive perforating collagenosis associated with hydronephrosis: successful treatment with allopurinol

patients (5.8%) had an onset of MF before the age of 20. Patients diagnosed with MF in young adulthood often report onset of their first symptoms in their teenage years. Many of the reported cases of childhood-onset MF were not diagnosed until biopsies were performed in adulthood. It is reported that the median time from symptom onset to diagnosis was 5.3 years. In our case, the lesions were first noticed at the age of 1.5, and biopsy specimens were obtained 3 years after onset of disease. Although MF may present in childhood with a variety of clinical findings including papules, plaques, poikiloderma, and hypopigmented macules, the most common presentation is limited or generalized patch-stage disease. Our patient had this presentation with a predilection for the abdomen and lower limbs. According to a review of nine children with MF, Tan et al. suggested that the majority had early stage of disease. Our case had also disease classified as stage T1. There are no established treatment protocols specially designed for children. Psoralen and ultraviolet A (PUVA) and UVB phototherapy are commonly used. Narrow-band phototherapy is more effective than broad-band phototherapy. A good response with topical PUVA treatment is also reported. Our patient received narrow-band phototherapy because of the adverse effects of systemic psoralen. In conclusion, we suggest that persistent skin lesions especially in childhood should be considered in the differential diagnosis of MF, although the biopsies are less likely to be performed in children, and narrow-band phototherapy may be appropriate for the management of childhood MF.