T cell lymphomatoid contact dermatitis: a challenging case and review of the literature

Abstract

SummaryLymphomatoid contact dermatitis is a pseudolymphoma with clinical and histological features of allergic contact dermatitis and cutaneous T cell lymphoma. Incorrect diagnosis may lead to unnecessary testing, unnecessary treatment, or patient harm. The objective of this study is to present a case to demonstrate the diagnostic challenge and overlap between allergic contact dermatitis and cutaneous T cell lymphoma in a patient with lymphomatoid contact dermatitis caused by methylchoroisothiazolinone/methylisothiazolinone and paraben mix, and to review the existing literature in order to summarize the demographics, clinical features, allergens and treatments reported for lymphomatoid contact dermatitis. A search of major scientific databases was conducted for English-language articles reporting cases of lymphomatoid contact dermatitis or additional synonymous search headings. Nineteen articles with a total of 23 patients were analysed. Lymphomatoid contact dermatitis was more common in men, with an average age of 58.5 years. Fourteen unique allergens were identified and confirmed by patch testing. However, no single test or study was diagnostic of lymphomatoid contact dermatitis. Allergen avoidance was the most useful management tool, but selected patients required topical or systemic immunosuppression. In conclusion, without specific diagnostic features, evaluation for lymphomatoid contact dermatitis should include a thorough history and examination, patch testing, and biopsy with immunohistochemistry and clonality studies.

Contact allergy caused by methylisothiazolinone: the Belgian-French experience

“…No respiratory complaints were observed, although reported [28]. Of note, isothiazolinones can cause unusual clinical manifestations such as lupus-like skin lesions [29], urticaria [30], or even mimic cutaneous T-cell lymphoma [31]. Interestingly, MI can also act as a relevant sensitizer at the mucosal level, for example in the anogenital region, due to the use of sexual lubricants or wet wipes [11], and also at the oral mucosa [14].…”

Eternal Spirituality: An Outstanding Aspect of Iranian Islamic Traditional Medicine

“…According to Islamic doctrine, the trust to God is sufficient for target achievement [46]. Of course, this trust won't be perfect without the human efforts [47]. This confidence turns on the light of hope, brighter than the past, in the patient's heart.…”

Infiltrados Linfocitários Cutâneos Simuladores de Linfoma

“…6 Histologicamente é evidente um infiltrado linfocitário denso na derme superficial, com presença de vesículas espongióticas intra-epidérmicas que simulam microabcessos de Pautrier-Darier mas, são constituídos maioritariamente por células de Langerhans, podendo conter também linfócitos pequenos (sem atipias e, em reduzido número) e queratinócitos ( Fig. 1).…”

“…As características distintivas consistem nos graus variáveis de acantose e espongiose, de maior intensidade nesta dermatose. 6,8 O diagnóstico é efectuado correlacionando estes dados histológicos com a clínica e, as provas epicutâneas que confirmam a etiologia.…”