Lymphomatoid Papulosis in Childhood With Exclusive Acral Involvement

Clinicopathologic challenge: acral lymphomatoid papulosis

“…Type A, the histiocytic subtype, consists of a wedge‐shaped superficial and deep dermal mixed‐cell infiltrate with variable numbers of large, atypical lymphocytes admixed with histiocytes, neutrophils, and eosinophils 3,10 . The lymphocytes have pleomorphic nuclei that resemble Reed–Sternberg cells 8 . Epidermotropism and adnexotropic infiltrates are occasionally observed 3,10 .…”

Acral lymphomatoid papulosis

“…Of the reported cases of acral lymphomatoid papulosis, one patient noted reduced time to regression with topical corticosteroids and intralesional gamma interferon. [1][2][3][4][5] Our patient noted faster resolution of lesions with topical or intralesional corticosteroids. Cetuximab-induced hypertrichosis of the scalp and eyelashes…”

“…1 Of the five previously reported cases of acral lymphomatoid papulosis, three patients had type A lesions, one had type C lesions, and the fifth was not categorized. [1][2][3][4][5] The case described here is type A lymphomatoid papulosis.…”

“…Reviewing the English language literature, there are only five reported cases of lymphomatoid papulosis localized to the acral surfaces to date. [1][2][3][4][5] Lymphomatoid papulosis is a CD30 1 lymphoproliferative disorder, to be distinguished from primary cutaneous anaplastic large cell lymphoma and borderline cases. Lymphomatoid papulosis classically presents with recurrent crops of self-healing papulonodules over the trunk and extremities that sometimes leave residual scarring.…”

“…The acral variants reported include reddish-brown and reddish-purple papules, which were tender, pruritic, or secondarily pustular, and rarely vesicular. [1][2][3][4][5] Three main histologic subtypes of lymphomatoid papulosis have been described. Type A lesions, the most common, are characterized by a wedge-shaped dermal infiltrate with large atypical CD30 1 cells.…”