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Lymphomatoid papulosis: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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The causes and pathogenesis of lymphomatoid papulosis remain unknown. Many scientists consider lymphomatoid papulosis as a nodular form of skin lymphoma with slow tumor progression. The disease is observed in young and middle-aged people, more often in men.
Symptoms of lymphomatoid papulosis. Clinically, the disease resembles guttate parapsoriasis, and histologically - true lymphoma. The lesions are located mainly on the trunk and limbs, as well as on the face, scalp, palms or genitals. The most characteristic are bluish-pink papules or papulovesicles with scales, crusts or areas of necrosis on the surface. The development cycle of individual elements, as a rule, is 4-6 weeks, sometimes ending in the formation of atrophic scars; hyperkeratotic plaques, dissolving nodes and bullous eruptions may be observed.
Lymphomatoid papulosis usually has a benign course from 6 months to 20 years.
Histopathology. In the epidermis, slight parakeratosis, acanthosis, spongiosis, and sometimes mononuclear cell exocytosis are detected. In the superficial layers of the dermis, there are infiltrates of T-lymphocytes with pronounced epidermotropism. In the middle and deep layers of the dermis, perivascular and periglandular infiltrates of lymphocytes with an admixture of atypical cells resembling convoluted T-lymphoblasts or immunoblasts may be observed. There may be mild signs of vasculitis.
Differential diagnosis should be made primarily with guttate parapsoriasis, papulonecrotic vasculitis and papulonecrotic tuberculosis. Histological examination is of decisive importance.
Treatment of lymphomatoid papulosis. Corticosteroids, high doses of tetracycline, PUVA therapy are prescribed. The positive effect of methotrexate has been described.
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