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Archives of Pathology & Laboratory... Oct 2014Mycosis fungoides is the most common primary cutaneous lymphoma; however, it remains a significant diagnostic challenge, in part because of the overlap with several... (Review)
Review
Mycosis fungoides is the most common primary cutaneous lymphoma; however, it remains a significant diagnostic challenge, in part because of the overlap with several inflammatory dermatoses. Despite advances in immunohistochemistry and molecular diagnostics, false-positive, false-negative, and indeterminate diagnoses are not uncommon. In most cases, the overall balance of morphologic, immunophenotypic, and genetic features must be considered carefully because there are few sensitive and specific clues to the diagnosis. Moreover, an appropriate clinical presentation is essential to the diagnosis and helps to favor or exclude inflammatory/reactive processes. Herein, we discuss 3 important inflammatory dermatoses that may closely simulate mycosis fungoides, and we review the use of ancillary studies in these challenging cases.
Topics: Adult; Dermatitis, Allergic Contact; Diagnosis, Differential; Drug Eruptions; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor; Humans; Lichen Sclerosus et Atrophicus; Male; Mycosis Fungoides; Phimosis; Prognosis; Pseudolymphoma; Skin; Skin Neoplasms
PubMed: 25268195
DOI: 10.5858/arpa.2014-0298-CC -
Acta Dermato-venereologica Oct 2022
Review
Topics: Humans; Pseudolymphoma; Hydroxychloroquine; Skin Diseases; Skin Neoplasms
PubMed: 36250760
DOI: 10.2340/actadv.v102.3201 -
Anais Brasileiros de Dermatologia 2013The authors describe a case of a female patient with Acral Pseudolymphomatous Angiokeratoma of Children, known as APACHE. It is a rare benign cutaneous disease, of... (Review)
Review
The authors describe a case of a female patient with Acral Pseudolymphomatous Angiokeratoma of Children, known as APACHE. It is a rare benign cutaneous disease, of unknown etiology, characterized by multiple, asymptomatic erythematous-violaceous papules and nodules, usually located unilaterally with acral distribution. Today, this denomination is questionable, since there are published reports of this disease in adults and in different locations. Clinically, it is similar to an angiokeratoma, whereas hystologically, it corresponds to a distinct type of pseudolymphoma. The immunohistochemical study is required to distinguish APACHE from cutaneous lymphoma.
Topics: Angiokeratoma; Biopsy; Child; Female; Humans; Immunohistochemistry; Pseudolymphoma; Skin Neoplasms
PubMed: 24346876
DOI: 10.1590/abd1806-4841.20132413 -
Journal of the American Academy of... Apr 2022Limited data on dermatoscopy of nodular/plaque-type T-/B-cell primary cutaneous lymphomas (PCLs) is available.
Dermatoscopy of nodular/plaque-type primary cutaneous T- and B-cell lymphomas: A retrospective comparative study with pseudolymphomas and tumoral/inflammatory mimickers by the International Dermoscopy Society.
BACKGROUND
Limited data on dermatoscopy of nodular/plaque-type T-/B-cell primary cutaneous lymphomas (PCLs) is available.
OBJECTIVE
To describe dermatoscopic features of nodular/plaque-type PCLs, comparing them with those of clinical mimickers (pseudolymphomas, tumors, and inflammatory lesions) and investigating possible differences according to histologic subtypes.
METHODS
Participants were invited to join this retrospective, multicenter case-control study by submitting histologically/immunohistochemically confirmed instances of nodular/plaque-type PCLs and controls. Standardized assessments of the dermatoscopic images and comparative analyses were performed.
RESULTS
A total of 261 lesions were included (121 PCLs and 140 controls). Orange structureless areas were the strongest PCL dermatoscopic predictor on multivariate analysis compared with tumors and noninfiltrative inflammatory dermatoses. On the other hand, a positive association was found between PCLs and either unfocused linear vessels with branches or focal white structureless areas compared with infiltrative inflammatory dermatoses, whereas white lines were predictive of PCLs over pseudolymphomas. Differences in the vascular pattern were also seen between B- and T-cell PCLs and among B-cell PCL subtypes.
LIMITATIONS
Retrospective design and the lack of a dermatoscopic-pathologic correlation analysis.
CONCLUSION
Nodular/plaque-type PCLs display dermatoscopic clues, which may partially vary according to histologic subtype and whose diagnostic relevance depends on the considered clinical differential diagnoses.
Topics: Breast Neoplasms; Case-Control Studies; Dermoscopy; Female; Humans; Lymphoma, B-Cell; Lymphoma, T-Cell, Cutaneous; Pseudolymphoma; Retrospective Studies; Skin Neoplasms
PubMed: 34695527
DOI: 10.1016/j.jaad.2021.10.020 -
Journal of Oral and Maxillofacial... 2016Small innocuous growths on the face usually do not pose difficulty in diagnosis on histopathology. However, some benign inflammatory lesions might mimic malignancy and...
Small innocuous growths on the face usually do not pose difficulty in diagnosis on histopathology. However, some benign inflammatory lesions might mimic malignancy and hence need further investigations for final diagnosis. The distinction between a benign/inflammatory/malignant lesion needs no emphasis as the treatment plan, prognosis and the patient's well-being depends on it. Lymphocytoma cutis, or Spiegler-Fendt Sarcoid, is classed as one of the pseudolymphomas, referring to inflammatory disorders in which the accumulation of lymphocytes on the skin resembles, clinically and histopathologically, cutaneous lymphomas. To obtain an accurate diagnosis, careful clinical evaluation, as well as histopathological and immunohistochemical examination is needed. One such case of an otherwise unassuming growth mimicking malignancy is being presented.
PubMed: 27601833
DOI: 10.4103/0973-029X.185909 -
Dermatology Online Journal Dec 2001
Topics: Aged; Diagnosis, Differential; Erythema; Humans; Lupus Erythematosus, Discoid; Lupus Erythematosus, Systemic; Male; Pseudolymphoma; Skin Diseases
PubMed: 12165230
DOI: No ID Found -
Life (Basel, Switzerland) Dec 2022The occurrence of skin lesions is the earliest symptom of Lyme disease, and the diagnosis of these lesions and appropriate treatment may prevent complications of the...
The occurrence of skin lesions is the earliest symptom of Lyme disease, and the diagnosis of these lesions and appropriate treatment may prevent complications of the disease, which are mainly neurological. The cutaneous presentation in borreliosis is heterogeneous. There are typical lesions that constitute the basis for the diagnosis of Lyme disease, and atypical ones, which cause significant diagnostic difficulties especially when the patient does not remember the tick bite. This study aims to describe the heterogeneous skin symptoms of Lyme borreliosis, as well as offer a practical approach for the recognition of the disease. Based on pediatric cases from clinical practice, rare cutaneous presentations of Lyme disease at various stages of illness and therapy are presented. Diagnostic recommendations for recognizing individual forms are discussed.
PubMed: 36676022
DOI: 10.3390/life13010072 -
Der Hautarzt; Zeitschrift Fur... Feb 2022The term cutaneous pseudolymphoma (C-PSL) is defined in the literature as a benign, reactive lymphoproliferation that clinically and/or histopathologically imitates...
The term cutaneous pseudolymphoma (C-PSL) is defined in the literature as a benign, reactive lymphoproliferation that clinically and/or histopathologically imitates cutaneous lymphoma. The exact etiopathogenesis has not been fully elucidated to date. A distinction is made between primary, idiopathic PSL without an identifiable cause and secondary PSL with a known stimulus. We report the occurrence of pseudolymphoma after treatment with medicinal leeches (hirudotherapy). To the best of our knowledge, a total of only nine cases of cutaneous PSL after hirudotherapy have been reported in the literature to date.
Topics: Humans; Lymphoma, Non-Hodgkin; Pseudolymphoma; Skin Neoplasms
PubMed: 33884433
DOI: 10.1007/s00105-021-04812-6 -
Microorganisms Feb 2024Tracing the profile of pediatric Lyme borreliosis (LB) in Europe is difficult due to the interregional variation in its incidence and lack in notifications. Moreover,...
Tracing the profile of pediatric Lyme borreliosis (LB) in Europe is difficult due to the interregional variation in its incidence and lack in notifications. Moreover, the identification of LB can be challenging. This study is an 18-year case series of 130 children and adolescents aged under 18 years referred to the Pediatric Infectious Diseases Unit at L. Sacco Hospital, Milan, with suspicion of LB, between January 2005 and July 2023. The routine serological workup consisted of a two-step process: an initial screening test followed by Western blot (WB). Forty-four (34%) patients were diagnosed with LB. The median age was six years, and 45% were females. Of the children with erythema migrans (EM), 33 (57%) were confirmed as having true EM, and, of these, 4 (12%) were atypical. Ten (23%) patients had early disseminated/late diseases, including facial nerve palsy ( = 3), early neuroborreliosis ( = 1), arthritis ( = 3), relapsing fever ( = 2), and borrelial lymphocytoma ( = 1). No asymptomatic infections were documented. Over seventy percent of confirmed LB cases ( = 31/44) recalled a history of tick bites; in this latter group, 19 (61%) were from the area of the Po River valley in Lombardy. Almost half of the children evaluated for LB complained of non-specific symptoms (fatigue, musculoskeletal pain, skin lesions/rash, and persistent headache), but these symptoms were observed in only two patients with confirmed LB. Most LB cases in our study were associated with EM; two-tier testing specificity was high, but we found frequent non-adherence to international recommendations with regard to the timing of serology, application of the two-step algorithm, and antibiotic over-prescription. Most children were initially assessed for a tick bite or a skin lesion suggestive of EM by a family pediatrician, highlighting the importance of improving awareness and knowledge around LB management at the primary healthcare level. Finally, the strengthening of LB surveillance at the national and European levels is necessary.
PubMed: 38543506
DOI: 10.3390/microorganisms12030455 -
The American Journal of Dermatopathology Jun 2008A retrospective histological and immunohistochemical study has been carried out in 25 cases of tick bites recorded in our Departments. The samples that included an...
A retrospective histological and immunohistochemical study has been carried out in 25 cases of tick bites recorded in our Departments. The samples that included an attached tick showed a cement cone anchoring the mouthparts to the skin and a blood-soaked, spongiform appearance of the superficial dermis, with a mild neutrophilic and eosinophilic infiltration. The vessels displayed a loose multilayered endothelial proliferation, with plump endothelia, permeated with erythrocytes. A few of them were severed, allowing copious blood extravasation. The established lesions included the following: erythema chronicum migrans-like cases, foreign body granulomas-sometimes containing remnants of the mouthparts-cutaneous lymphoid hyperplasia, either of the T-cell or the B-cell type, and tick-bite alopecia. In both the T-cell and B-cell pseudolymphomas, several vessels showed concentric endothelial and perithelial proliferation similar to that seen in the acute lesions. In the tick-bite alopecia, a lymphocytic infiltrate attacked the permanent portion of the hair follicles, whose reaction was a noticeable hyperplasia of the fibrous sheaths, although only a minority of the hairs was destroyed. The observed alterations are specific in the acute lesions and in the alopecia, where they directly arise as a result of the interactions between the host's tissues and the antihemostatic, anti-inflammatory, and immunomodulatory chemicals contained in the tick saliva. In the other lesions, the changes seem less characteristic, although the fragments of mouthparts and the special vascular changes provide a clue to their etiology.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Alopecia Areata; Animals; B-Lymphocytes; Child; Erythema Chronicum Migrans; Female; Host-Parasite Interactions; Humans; Insect Bites and Stings; Ixodes; Male; Middle Aged; Pseudolymphoma; Retrospective Studies; Skin Diseases; T-Lymphocytes
PubMed: 18496425
DOI: 10.1097/DAD.0b013e3181676b60