Mimics of Cutaneous Lymphoma

Sarantopoulos, G. Peter; Palla, Beth; Said, Jonathan; Kinney, Marsha C.; Swerdlow, Steven M.; Willemze, Rein; Binder, Scott W.

doi:10.1309/ajcpx4bxtp2qbrko

Cited by 51 publications

(18 citation statements)

References 92 publications

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“…This was confirmed by other studies that researched the overlapping histopathologic features of MF and psoriasis (Doukaki et al, 2009, Jinno et al, 2015), lichen (Citarella et al, 2003, Magro et al, 1997, Suchak et al, 2010), eczema (Ackerman et al, 1974, Ecker and Winkelmann, 1981, LeBoit and Epstein, 1990, Miyagaki and Sugaya, 2011, Orbaneja et al, 1976, Reddy and Bhawan, 2007, Solomon et al, 2016, White, 1990), pseudolymphoma (Choi et al, 2003, Rijlaarsdam et al, 1991, Rijlaarsdam et al, 1992), cutaneous drug reactions (Sarantopoulos et al, 2013), parapsoriasis (Goldberg, 2012), chronic and nonspecific dermatitis (Elmer and George, 1999), and others dermatosis (Deen et al, 2015, Fujimoto et al, 2015, Kazlouskaya et al, 2015, Lim et al, 2015, Rodriguez-Acosta et al, 2013, Yalcin et al, 2014). …”

Section: Discussionsupporting

confidence: 73%

Defining the mimics and clinico-histological diagnosis criteria for mycosis fungoides to minimize misdiagnosis

Kelati

Gallouj

Tahiri

et al. 2017

International Journal of Women's Dermatology

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BackgroundMycosis fungoides (MF) is a significant diagnostic challenge; it has various differential diagnosis especially at an early stage. Our aim was to describe mimics of MF clinically and histologically, and to define significant diagnostic criteria of the disease.MethodsThis was a retro-prospective cohort of 370 patients in whom the diagnosis of MF was suspected clinically.ResultsMF was histologically confirmed in 15.4% of cases and rejected in 84.5%. Other identified histologically diagnosis were eczema, psoriasis; nonspecific dermatitis, lichen, lupus; pseudolymphoma, parapsoriasis and toxidermia. 4 patients with palmoplantar MF were wrongly treated as eczema, and 10 patients with psoriasiform MF were initially treated as psoriasis. We also described the clinical, histological and immunohistochemistry diagnostic criteria for distinguishing MF from benign dermatosis.ConclusionsMisdiagnosis of MF was a real problem for this study, because it shared common clinical and histological characteristics with other inflammatory diseases like eczema and psoriasis. Therefore, defining significant clinico-histological diagnosis criteria of MF would be of great help and would increase the accuracy of the diagnosis.

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Section: Discussionsupporting

confidence: 73%

Defining the mimics and clinico-histological diagnosis criteria for mycosis fungoides to minimize misdiagnosis

Kelati

Gallouj

Tahiri

et al. 2017

International Journal of Women's Dermatology

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“…Drugs well known to induce cutaneous B-cell pseudolymphomas are antidepressants, whereas phenytoin-induced cutaneous pseudolymphomas are mostly T-cell predominant. [ 7 ] We believe ours to be B-cell pseudolymphoma as majority of the atypical cells were CD20 positive. Usually B-cell pseudolymphomas appear as solitary lesions, but rarely can occur with multiple papules and plaques as observed by us.…”

Section: Discussionmentioning

confidence: 95%

Phenytoin induced cutaneous B cell pseudolymphoma

et al. 2015

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Cutaneous pseudolymphomas are benign lymphoproliferative processes mimicking lymphomas clinically and histologically. One of the precipitating factors for pseudolymphoma is drugs like anticonvulsants, antidepressants and angiotensin-converting enzyme inhibitors. According to existing literature phenytoin-induced cutaneous pseudolymphomas are usually T-cell predominant. Most often withdrawal of the drug with or without short-course systemic steroids can attain a cure. Rarely malignant transformation has been reported years later despite withdrawal of the offending drug, which necessitates a long-term follow up of the affected. We report an 80-year-old male patient who was receiving phenytoin sodium and who presented with diffuse erythema and infiltrated skin lesions which histologically resembled cutaneous B-cell lymphoma. Substituting phenytoin with levetiracetam achieved resolution of symptoms. Further evaluation was suggestive of a reactive process. A detailed drug history is of paramount importance in differentiating drug-induced pseudolymphoma from lymphoma. Searching literature we could not find any previous reports of phenytoin-induced cutaneous B-cell pseudolymphoma.

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“…[ 3 ] Many authorities support the view that PPD represents a form of T-cell dyscrasia within the spectrum of cutaneous T-cell lymphoma. [ 2 ] Considerable overlap is observed between the features of cutaneous T-cell lymphoma and PPD.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 ] With reports of PPD evolving into mycosis fungoides over the years it is recommended that atypical PPD, especially the widespread forms should be evaluated for T-cell clonality with close monitoring of the monoclonal variants. [ 2 3 ] Here we report a 31-year-old male patient who manifested PPD confined to legs, which had features of mycosis fungoides on histological analysis.…”

Section: Introductionmentioning

confidence: 99%

Pigmented purpuric dermatosis or mycosis fungoides: A diagnostic dilemma

Riyaz

Sasidharanpillai

Latheef

et al. 2016

Indian Dermatol Online J

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Pigmented purpuric dermatoses (PPD), a group of vascular disorders with variable clinical picture is reported in all races and age groups with a male predilection. There are reports of mycosis fungoides manifesting as pigmented purpura as well as progression of PPD to cutaneous T-cell lymphoma. The diagnostic dilemma is compounded by PPD manifesting histological similarity to mycosis fungoides. Currently, it is believed that PPD with monoclonal T-cell population is more likely to progress to malignancy. We report a 31-year-old male patient who presented with the lichenoid clinical variant of PPD lesions that mimicked mycosis fungoides on histopathology. Gene rearrangement studies identified a polyclonal T-cell population. The patient responded to photochemotherapy, which is beneficial in both PPD and mycosis fungoides. Our case signifies the limitations of current diagnostic modalities in accurately distinguishing PPD from cutaneous lymphoma. Data on disease progression in similar cases may enable us to formulate better diagnostic definitions.

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Mimics of Cutaneous Lymphoma

Cited by 51 publications

References 92 publications

Defining the mimics and clinico-histological diagnosis criteria for mycosis fungoides to minimize misdiagnosis

Defining the mimics and clinico-histological diagnosis criteria for mycosis fungoides to minimize misdiagnosis

Phenytoin induced cutaneous B cell pseudolymphoma

Pigmented purpuric dermatosis or mycosis fungoides: A diagnostic dilemma

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