Jessner’s Lymphocytic Infiltration of the Skin: A CD8+ Polyclonal Reactive Skin Condition

Abstract

Background: Jessner’s lymphocytic infiltration of the skin (JLIS) is a clinically and histologically distinct disease entity. Conflicting results have been reported concerning its differentiation from cutaneous lupus erythematosus and polymorphous light eruption, its relationship to palpable migratory arciform erythema and its classification as a B-cell or a CD4+ T-cell lymphoproliferative disease. Objective: Our study was performed in order to re-evaluate JLIS clinically and by immunohistochemical and molecular analyses. Methods: Stringent inclusion/exclusion criteria were used to collect a cohort of 34 patients with JLIS that did not overlap with lupus erythematosus or polymorphous light eruption. Clinical data were analysed, and immunohistochemical and molecular studies were performed including TCR-γ PCR GeneScan software analysis of tissue and peripheral blood samples. Results: In the majority of the patients, the lesions consisted only of papules and plaques while in 12% annular lesions were also seen. The lesions were found on the face (38%), on the trunk and arms (50%) or at both sites (12%). Immunohistochemical analyses revealed a clear predominance of T cells in all patients, and of CD8+ T cells in 77% of the patients. As judged by TCR-γ PCR GeneScan analysis, 98 and 79% of the tissue and peripheral blood samples, respectively, showed a polyclonal T-cell population; identical T-cell clones were not detected concomitantly in both the skin and the peripheral blood of the same patient. Conclusions: JLIS occurs at 2 major predilection sites, that is the face and trunk. Therefore introduction of palpable migratory arciform erythema as a separate entity is not justified. The lymphoid infiltrates are dominated immunohistochemically by CD8+ T cells that do not show clonality on molecular analysis. Thus, JLIS represents a characteristic CD8+ polyclonal reactive skin condition.

Paucity of FOXP3+ cells in skin and peripheral blood distinguishes Sézary syndrome from other cutaneous T-cell lymphomas

“…Hematoxylin and eosin, CD4 (clone 1F6, Novocastra, Newcastle upon Tyne, UK) and CD25 (clone 4C9, Dianova, Hamburg, Germany) stainings were performed as described. 14 For FOXP3 staining, we used 4 mm sections, FOXP3 IgG1 antibody (Ab) 236A/E7 (AHB, GR) or mouse IgG1 isotype control (Dako, Glostrup, Denmark) and followed the published protocol. 15 All specimens were blinded and analyzed by two independent investigators (CDK, NP) as described.…”

Polymerase chain reaction-based clonality testing in tissue samples with reactive lymphoproliferations: usefulness and pitfalls. A report of the BIOMED-2 Concerted Action BMH4-CT98-3936

“…In biological terms, histologically reactive lesions represent a broad spectrum of lesions ranging from heterogeneous, polyclonal lymphocytes, via true reactive lymphoproliferations, to proliferations containing (oligo)clonally activated lymphoid cell populations or even a monoclonal component. [5][6][7][8][9][10][11] Reactive lymphoproliferations in lymph nodes or other tissues arising upon infection with micro-organisms (e.g. Epstein-Barr virus (EBV), cytomegalovirus, human immunodeficiency virus infections, toxoplasmosis, tuberculosis, cat scratch disease) or being associated with particular inflammatory processes (e.g.…”

Jessners Lymphocytic Infiltration of Skin Sucessful Treatment With Prednisolone and Hydroxy Chloroquine

“…(9) Histopathologically JLIS is characterized by a superficial and deep, primarily perivascular, sleeve-like lymphocytic dermal infiltrate with a predominance of small mature polyclonal lymphocytes and without epidermal involvement. (2,10) Deposits of mucin in the reticular dermis have been described. (6) However, other authors have been unable to demonstrate mucin in JLIS.…”