cutaneous pseudolymphoma

Etiology

• drug eruption
• reactions to tattoo dyes
• reaction to jewelry (especially gold)
• insect bites
• folliculitis
• trauma
• infections
  • Borrelia
  • varicella-zoster virus
  • molluscum contagiosum
• vaccinations

Epidemiology

• uncommon
• female to male ratio is 2:1
• mean age of onset is 34 years
• 90% of patients are white

Pathology

• inflammatory response that results in a lymphomatous-appearing but benign accumulation of inflammatory cells
• resemblance to lymphoma is usually most apparent histologically
• some cases may also mimic lymphoma clinically

Clinical manifestations

• 2 patterns
  • B-cell pattern
    • presentation with a cutaneous nodule or a group of discrete nodules, usually with minimal associated symptoms
  • T-cell pattern
    • broader cutaneous patche
    • often symptomatic

Laboratory

• skin biopsy
• Borrelia burgdorferi serology
• Borrelia burgdorferi DNA

Complications

• lymphoma

Differential diagnosis

• contact dermatitis
• lymphomatoid papulosis

Management

• not a lethal disorder
• removal of offending agent
• elective surgery:
  • simple excision of the involved site can be curative in some cases
• surgical resection, cryosurgery, or local radiation therapy
• topical glucocorticoids, glucocorticoid injections & topical tacrolimus have been used
• observation for emergence of lymphoma

More general terms

• inflammation
• skin disease (dermatologic disorder, dermatopathy, dermatosis)