Lymphocytoma cutis (aka pseudolymphoma) is a dermal collection of lymphocytes and other inflammatory cells. The key initial intervention is to exclude malignancy, e.g. leukemia or lymphoma cutis. There are reports of lymphocytoma cutis eventuating into a B-cell lymphoma. In some cases, particularly in Europe, Borrelia has been associated. Various drugs have been reported to stimulate lesions that mimic lymphoma, so called drug-induced pseudolymphoma.
A 0.5 -2 cm, asymptomatic, erythematous to plum-colored papule or nodule is characteristic. They may occur virtually anywhere with a special predilection for the ear lobes. A miliarial type occurs.
B cell: reactive to bites, piercings tattoo dyes, drugs, borrelia
T cell: The erythrodermic pseudolymphoma (T-cell pattern) typifies drug-induced pseudolymphoma, which is most often secondary to anticonvulsant therapy.
4 mm punch biopsy with immunohistologic staining. Clonal gene rearrangement analysis can also be done. Rule out Borrelia.
Therapy need not be done, as spontaneous resolution may occur. If desired, intralesional triamcinolone (e.g. 5-10 mg/cc) is usually quite effective and should be first line therapy. Cryotherapy has also been used.
If Borrelia is present, treat. If drug-induced, stop the drug.
Pseudolymphoma, the miliarial type.
Homepage | Who is Dr. White? | Privacy Policy | FAQs | Use of Images | Contact Dr. White