Dermoscopy of different stages of lymphomatoid papulosis (original) (raw)
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The importance of histopathology findings in lymphomatoid papulosis
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2014
Lymphomatoid papulosis, part of the controversial group of cutaneous lymphoproliferative pseudolymphoma disorders, raises important clinical and histopathological problems. It is a chronic, recurrent, clinically characterized by popular necrotic lesions and papulo-pustular nodules, sometimes self-limiting and characterized by histopathological changes suggestive of cutaneous lymphoma (CD30-positive). Since its introduction, in 1968, the term "lymphomatoid papulosis" was subject to dispute in terms of classification in malignancies, premalignant or benign skin disease. We submit for consideration the case of a man with papulo-necrotic skin lesions evolving for about one year with post therapeutic remission and relapses, with histopathology of lymphomatoid papulosis. The evolution under systemic glucocorticoids has been favorable, with remission of skin lesions in about three months without relapses to date.
Clinical Case of Lymphomatoid Papulosis
Archive of Clinical Medicine
Lymphomatoid papulosis is a rare skin disease. The incidence averages 1.5 cases per 1 million population. It is the most common in adults around the age of 40. It was previously considered as paraneoplastic dermatosis, but recent studies have confirmed that lymphomatoid papulosis is a primary CD30 + T-lymphoma of the skin. Despite the aggressive morphological features, it is benign. The disease is characterized by a tendency to spontaneous regression. Typically, skin lesions last 3-12 weeks, although in some severe cases they may last longer. Skin lesions may disappear or recur over decades. Patients require observation because a second lymphoproliferative disease develops in 10-40% of patients. A case of lymphomatoid papulosis in a patient with diffuse astrocytoma is presented. The patient was treated with systemic retinoids. The results of differential diagnosis and additional research methods, including dermoscopy, are given. Although the use of dermoscopy was not cruci...
Lymphomatoid papulosis: a study of 18 cases*
Journal of the European Academy of Dermatology and Venereology, 1992
Lymphomatoid papulosis (LyP) is a cutaneous eruption that is clinically benign but histologically malignant. To date, more than 300 cases have been published. About 10-20% of the patients develop a lymphoma. The purpose of this study was to make a clinicopathological study of 18 patients diagnosed with LyP in our hospital from 1973 to 1990, to characterize cellular infiltrates in the lesions, to find clonal populations of T-cells and to look for predictive factors of malignant lymphoma in LyP patients. Mean age was 48.7 years. The most frequent clinical lesions were papules (88.8%) followed by plaques (38.8%). The localizations were on extremities (loo%), trunk (88%), face (22%), palms or soles (ll%), perigenital(ll%) and scalp (5%). Two patients have been free of disease for more than 5 years. IgA levels are increased in LyP patients. Neither HTLV I nor 111 can be considered as a cause of the LyP in any of our patients. Associated diseases were found in 6 cases (1 mycosis fungoides, 1 Hodgkin's disease, 2 anaplastic large-cell lymphoma and 2 large plaque parapsoriasis). Some types of parapsoriasis should be included in the 'spectrum of Ki-1 lymphomas'. 52 skin biopsies were studied. 17% were type A of Willemze, 67% were type B and 15% were transitional. In 12 of the samples follicular or perifollicular infiltration was found. Follicular LyP should not be considered as a distinct type of LyP. Vasculitis is an uncommon finding in LyP. In all the cases studied, large atypical cells were CD30 + ; 5/7 cases had lost CD5 and 4/5 cases had lost CD7. In one case, all T-cell antigens were negative. Cerebriform mononuclear cells were always recognized by T-cell antibodies and they were CD30 positive in only two cases. In one case there were more
Histopathological aspects and differential diagnosis of CD8 positive lymphomatoid papulosis
Journal of Cutaneous Pathology, 2016
Lymphomatoid papulosis (LyP) belongs to the group of CD30+ lymphoproliferative disorders in the WHO/EORTC Classification of Cutaneous T-cell lymphomas.(1) Clinical manifestation of LyP is characterized by waxing and waning papules, small nodules with varying degrees of central haemorrhage, ulceration and necrosis.(2) LyP eruptions evolve and regress within weeks without significant systemic symptoms. The prognosis is favourable except cases with preceding, simultaneous or subsequent association of secondary lymphomas. Mycosis fungoides (MF), anaplastic large cell lymphoma (ALC) and Hodgkin lymphoma occur in 10-30 per cent of LyP cases.(3-7) Three classic subtypes (A,B,C) of LyP with distinct histopathologic characteristics were defined.(8) The atypical cell component of types A and C are large cells with CD4+/CD30+ phenotype(8), while in type B the characteristic epidermotropic infiltrate is composed of CD4+ atypical small lymphoid cells that express weak CD30 antigen or may show CD30 negativity.
Cells
Lymphomatoid papulosis (LyP) is a very rare disease that belongs to the group of CD30+ lymphoproliferative skin diseases. LyP is localized or generalized and usually presents as isolated or clustered red/brown-red lesions in the form of nodules and/or papules. The course of the disease is in most cases mild; however, depending on concomitant risk factors and history, it may progress to lymphoma, significantly reducing the survival rate and prognosis. Importantly, the clinical picture of the disease remains somewhat ambiguous, leading to a large number of misdiagnoses that result in inappropriate treatment, which is usually insufficient to alleviate symptoms. In addition to clinical manifestations, the histological characteristics vary widely and usually overlap with other conditions, especially those belonging to the group of lymphoproliferative disorders. Although diagnosis remains a challenge, several recommendations and guidelines have been introduced to standardize and facilitat...
International Journal of Dermatology, 2005
Background Neoplasia-induced lichen planus is described as a cell-mediated reaction to unknown epithelial antigens. Paraneoplastic pemphigus (PNP), characterized by the presence of a specific array of autoantibodies, probably represents a different form of presentation of the same autoimmune syndrome where the mucocutaneous expression depends on the dominant pathologic mechanism.
Paraneoplastic pemphigus as the initial presentation of chronic lymphocytic leukemia
Annals of oncology : official journal of the European Society for Medical Oncology / ESMO, 2001
The case history of a 61-year-old male patient is described, who presented with severe stomatitis, conjunctivitis and leukocytosis. The diagnosis chronic lymphocytic leukemia (CLL) stage A (0) was made, for which no treatment was necessary. Progression of stomatitis and conjunctivitis and erythosquamous skin lesions with bullae and vesiculae formation developed. Under the diagnosis of bullous pemphigoid the patient was treated with corticosteroids. The histologic and immunofluorescence examination of a skin biopsy was compatible with this diagnosis, and antibodies to skin could not be detected in a first serum sample. Pseudomonas was cultured from all lesions, the corticosteroids were stopped and antibiotic treatment was started, without clear effect. Because of progression of skin lesions and debilitation, the patient finally declined all treatment and died five weeks after admission. Post-mortem examination showed enlarged lymphnodes in the cervical, aortal en iliacal areas, with ...