Dermoscopy of primary cutaneous B‐ and T‐cell lymphomas and pseudolymphomas presenting as solitary nodules and tumors: a case‐control study with histopathologic correlation

Abstract

Background Primary cutaneous lymphomas (PCLs) and pseudolymphomas presenting as single pink-red nodules/tumors are highly unspecific and include a wide differential diagnosis.Objective To describe the dermoscopic characteristics of PCL/pseudolymphoma. MethodsIn this retrospective, case-control study, we evaluated the dermoscopic features of patients with solitary PCL/pseudolymphoma tumors and compared them to a control group of non-lymphomatous, nonpigmented, solitary tumors (e.g., basal cell carcinoma, amelanotic melanoma, etc). ResultsWe included 14 patients with PCL/pseudolymphomas and 35 controls. T-cell and B-cell lymphoma proportions were 28.6% (n = 4) and 71.4% (n = 10), respectively.Compared to controls, most lymphomas presented dermoscopically with orange color (71.4% vs. 14.2%, P < 0.001), follicular plugs (85% vs. 2.8%, P < 0.001), and as organized lesions (85% vs. 31.4%, P = 0.001). Coexistence of orange color and follicular plugs had an odds ratio (OR) of 2.8 (P < 0.001), highly suggestive of PCL. The kappa index for independent observers was 0.66, 0.49, 0.43 for orange background, follicular plugs, and organized lesion, respectively. Histopathologic correlation was performed in six PCL cases and showed dense diffuse and perifollicular lymphocytic infiltrate in all cases and keratin plugs in five of six cases, possibly correlating with the orange color and the follicular plugs, respectively.Conclusion Primary cutaneous lymphomas/pseudolymphomas present with characteristic dermoscopic findings irrespective of immunohistochemical subtype.

The dermatoscopic spectrum of cutaneous lupus erythematosus: A retrospective analysis by clinical subtype with clinicopathological correlation

“…While in our study we were not able to correlate it with a certain histologic alteration, it has been described in the literature that dense monomorphous lymphocytic infiltrate may result in faint orange color in dermatoscopy. This finding has been reported only in patients with lymphoma and pseudo lymphoma, and not in patients with CLE so far 14 …”

“…This finding has been reported only in patients with lymphoma and pseudo lymphoma, and not in patients with CLE so far. 14 Lallas et al reported a significant correlation between gray color in dermatoscopy and the presence of melanophages in histology. 6 Gray color as a dermatoscopic feature was not represented in a high In our study, there was a significant overlap in the dermatoscopic features observed within the three groups.…”

Dermoscopic and trichoscopic features of primary cutaneous lymphomas – systematic review

“…Although direct dermoscopic–histopathological correlation of these structures has not been poorly investigated, the presence of salmon‐coloured background may correlate with atypical lymphocytic infiltrate within the dermis associated with neoangiogenesis. White structures could be associated either with reactive fibrosis in the dermis or with focally reduced grenz zone due to patchy, nodular, more superficial infiltrate in the papillary dermis 46,49 …”

Linfomas cutáneos: serie de casos en México

“…Un aspecto importante en estos padecimientos es el diagnóstico, que en la mayoría de los casos no se realiza de forma temprana debido a las manifestaciones que se confunden con padecimientos de comportamiento benigno. Es necesario referir a los pacientes con manifestaciones clínicas de sospecha al dermatólogo, para que se realice una evaluación minuciosa, incluyendo una dermatoscopia, en busca de características orientadoras del diagnóstico de LC, como son las áreas bien organizadas con fondo color salmón, vasos serpiginosos y tapones foliculares 11 .…”