Lymphomatoid papulosis: causes, symptoms, diagnosis, treatment

The causes and pathogenesis of papulosis of the lymphomatoid remain unknown. Many scientists consider papulosis lymphomatoid as a nodular form of skin lymphoma with a slow tumor progression. The disease is observed in young and middle-aged people, more often in men.

Symptoms of Papulosis of Lymphoma. Clinically, the disease resembles a drop-shaped parapsoriasis, and histologically - a true lymphoma. Foci of lesion are located mainly on the trunk and extremities, as well as on the face, scalp, palms or genitals. The most characteristic are cyanotic-pink papules or papulesvezicles with scales, crusts or areas of necrosis on the surface. The cycle of development of individual elements, as a rule, is 4-6 weeks, sometimes ends with the formation of atrophic scars; may be observed gillerkeraticheskie plaques, disposed nodes and bullous rashes.

Lymphoma papulosis usually has a benign course from 6 months to 20 years.

Histopathology. In the epidermis, minor parakeratosis, acanthosis, spongiosis, and sometimes exocytosis of mononuclear cells are revealed. In the superficial layers of the dermis - infiltrates from T-lymphocytes with pronounced epidermotropism. In the middle and deep layers of the dermis, perivascular and periglundular infiltrates of lymphocytes with an admixture of atypical cells resembling convoluted T-lymphoblasts or immunoblasts can be observed. There may be indistinct signs of vasculitis.

Differential diagnosis must be carried out first with drop-like parapsoriasis, papulonectrotic vasculitis, and papulonecrotic tuberculosis. In this case, histological research is of decisive importance.

Treatment of papulosis lymphoma. Assign corticosteroids, large doses of tetracycline, PUVA-therapy. A positive effect of methotrexate is described.

[1], [2], [3], [4], [5], [6]