Cutaneous pseudolymphoma at the site of prior herpes zoster eruption

Abstract

A 55-year old woman with a history of herpes zoster in the dermatome supplied by the mandibular branch of the trigeminal nerve developed cutaneous red papules and umbilicated nodules within the same segment. The clinical and histological diagnosis was pseudolymphoma. The lesions showed a polymorphous infiltrate without germinal center formation. Immunologic phenotyping with monoclonal antibodies revealed the predominance of helper T cells and distinct compartmentalization of B and T cells. The lesions healed up within 7 weeks. The development of pseudolymphomas at the site of previous herpes zoster eruptions seems to be extremely rare.

Granuloma Formation in Herpes Zoster Scars

“…A granulomatous infiltrate at the site of herpes zoster scarring has now been reported in a total of 7 patients [1, 2.4] and pseudolymphoma in a further 2 [3], though biop sies of herpes zoster scars are rarely performed and the incidence may be considerably higher than this figure sug gests. The aetiology of this reaction is obscure, but sugges tions that it may be due to an atypical delayed hypersensi tivity reaction to the zoster virus seems likely, particularly as 3 reported cases have been in patients immunocompro mised by chronic lymphocytic leukaemia.…”

“…Fischer and Jaworski [2] reported granuloma formation in herpes zoster scars in a patient with chronic lymphocytic leukaemia. Wolff et al [3] report on 2 cases of pseudolymphoma at the site of herpes zoster scars, one of these patients also had chronic lymphocytic leukaemia.…”

“…Biopsy of a lesion showed granuloma formation. The rash resolved spontaneously over 6 -8 weeks.A variety of lesions have been reported occurring at the site of herpes zoster scars including granuloma annulare [1.2], sarcoid-like granulomas [2] and pseudolymphomas [3], We present the case of a rash consisting of sarcoid-like granulomas occurring 3 months after an episode of dis seminated herpes zoster infection in a patient with chronic lymphocytic leukaemia. …”

Koebner Phenomenon in Lichen sclerosus et atrophicus

“…Class III was reported to be involved in melanoma, with decreased Bf-FF and increased Bf-S alleles [3,4], and in familial melanoma, with a decreased C4AOO frequency [5]. Class III was referred to be involved also in sporadic vitiligo, with a decreased C4AQO frequency [6].…”

“…KP also occurs at recent reparation sites in cases where the charac ter of the lesion might lead to cicatrization -cutaneous pseudolym phoma after herpes zoster [5], drug eruption after radiodermatitis [6], A general common feature present in KP is epidermal lesion; the necessity of the presence of a dermal inflammatory reaction seems to be probable in most cases. We suppose that also local congestion from the failure of lymphatic drainage in the scar [7) may play an important role in the development of KP.…”