Jessner Lymphocytic Infiltration of the Skin 

  • Author: Bassam Zeina, MD, PhD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jun 9, 2010
 

Background

Jessner and Kanof[1] first described this uncommon condition in 1953. The condition now known as Jessner lymphocytic infiltration of the skin (LIS) has remained poorly understood, and indeed, the very existence of such a condition has been questioned. One argument is that patients with this condition are simply displaying the early manifestations of some other disorder. Older literature would suggest that this is not correct and that certain patients monitored for as long as 30 years remain within the spectrum of lymphocytic infiltration of the skin with no progression. However, more recent literature suggests that lymphocytic infiltration of the skin cannot be separated from lupus erythematosus tumidus (LET) clinically, histologically, or photobiologically.[2]

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Pathophysiology

Whether Jessner lymphocytic infiltrate constitutes a separate disease entity and to what extent it is related to lupus erythematosus and other benign cutaneous lymphocytic infiltrates is not entirely clear. The following 4 views have been expressed:

  • It represents an entirely separate entity.
  • Although some cases represent a separate entity, other reported cases are discoid lupus erythematosus (DLE).
  • All cases are DLE or LET, which is a subtype of DLE.
  • It represents an initial phase or abortive stage of any of the other diseases with a patchy dermal lymphocytic infiltrate.

Lymphocytic infiltration of the skin can be viewed as a broad-spectrum photosensitivity disorder, which may demonstrate a delayed provocative phototest reaction. The relationship to sun exposure, consequently, is not always noted by the patient.[3]

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Epidemiology

Frequency

United States

The frequency of this condition in the United States is unknown.

International

The incidence and prevalence internationally is unknown. It is considered uncommon.

Mortality/Morbidity

Lymphocytic infiltration of the skin is not associated with increased mortality. The lesions are commonly asymptomatic, although some patients report burning or pruritus.

Race

Lymphocytic infiltration of the skin has no known racial predilection.

Sex

The reported sex ratio varies depending upon the source consulted. Some have reported a male-to-female ratio as high as 10:1, while others have noted a slight female predominance.

Age

Lymphocytic infiltration of the skin affects mostly adults younger than 50 years. It has been reported in children. Familial occurrence has been reported.[4]

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Contributor Information and Disclosures
Author

Bassam Zeina, MD, PhD  Consulting Staff, Department of Dermatology, Milton Keynes Hospital, UK

Bassam Zeina, MD, PhD is a member of the following medical societies: British Association of Dermatologists, British Medical Association, and Royal Society of Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Marjan Shah, MBBS, Msc Dermatology (UK)  Specialty Physician in Dermatology, Milton Keynes NHS Trust, UK

Disclosure: Nothing to disclose.

Sohail Mansoor, MBBS, MSc  Dermatologist and Lead Physician in Dermatologic Surgery, Department of Dermatology, Barnet Hospital, UK

Sohail Mansoor, MBBS, MSc is a member of the following medical societies: American Academy of Anti-Aging Medicine, American Academy of Dermatology, American Society for Dermatologic Surgery, Royal College of Physicians and Surgeons of Glasgow, and Royal College of Physicians of the United Kingdom

Disclosure: Nothing to disclose.

Specialty Editor Board

Peter Fritsch, MD  Chair, Department of Dermatology and Venereology, University of Innsbruck, Austria

Peter Fritsch, MD is a member of the following medical societies: American Dermatological Association, International Society of Pediatric Dermatology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Daniel S Loo, MD  Associate Professor of Dermatology, Residency Program Director, Department of Dermatology, Tufts Medical Center

Daniel S Loo, MD is a member of the following medical societies: American Academy of Dermatology and Association of Professors of Dermatology

Disclosure: Nothing to disclose.

Glen H Crawford, MD  Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital

Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

  1. Jessner M, Kanof NB. Lymphocytic infiltration of the skin. Arch Dermatol. 1953;68:447-9.

  2. Weber F, Schmuth M, Fritsch P, Sepp N. Lymphocytic infiltration of the skin is a photosensitive variant of lupus erythematosus: evidence by phototesting. Br J Dermatol. Feb 2001;144(2):292-6. [Medline].

  3. Adamski H, Labrousse AL, Sparsa A, Leonard F, Le Gall F, Labrousse F, et al. [Positive photobiological investigation in Jessner's lymphocytic infiltration of the skin]. Ann Dermatol Venereol. Dec 2002;129(12):1370-3. [Medline].

  4. Dippel E, Poenitz N, Klemke CD, Orfanos CE, Goerdt S. Familial lymphocytic infiltration of the skin: histochemical and molecular analysis in three brothers. Dermatology. 2002;204(1):12-6. [Medline].

  5. Ashworth J, Turbitt M, MacKie R. A comparison of the dermal lymphoid infiltrates in discoid lupus erythematosus and Jessner's lymphocytic infiltrate of the skin using the monoclonal antibody Leu 8. J Cutan Pathol. Aug 1987;14(4):198-201. [Medline].

  6. Poenitz N, Dippel E, Klemke CD, Qadoumi M, Goerdt S. Jessner's lymphocytic infiltration of the skin: a CD8+ polyclonal reactive skin condition. Dermatology. 2003;207(3):276-84. [Medline].

  7. Laurinaviciene R, Clemmensen O, Bygum A.Successful treatment of Jessner's lymphocytic infiltration of the skin with methotrexate.Acta Derm Venereol .2009;89(5):542-3 [database online].

  8. Wu JJ, Huang DB, Pang KR, Hsu S, Tyring SK. Thalidomide: dermatological indications, mechanisms of action and side-effects. Br J Dermatol. Aug 2005;153(2):254-73. [Medline].

  9. Hafejee A, Winhoven S, Coulson IH. Jessner's lymphocytic infiltrate responding to oral auranofin. J Dermatolog Treat. Sep 2004;15(5):331-2. [Medline].

  10. Green CM.Clin Exp Dermatol.Successful treatment of Jessner's lymphocytic infiltrate with auranofin.Clin Exp Dermatol. 2008 Jan;33(1):108-9 [database online].

  11. Borges da Costa J, Boixeda P, Moreno C. Pulsed-dye laser treatment of Jessner lymphocytic infiltration of the skin. J Eur Acad Dermatol Venereol. Sep 1 2008;[Medline].

  12. Anderson NP, Newman BA, Feldman FF. Lymphocytic infiltration of the skin. Arch Dermatol. 1954;70:832.

  13. Arai E, Shimizu M, Hirose T. A review of 55 cases of cutaneous lymphoid hyperplasia: reassessment of the histopathologic findings leading to reclassification of 4 lesions as cutaneous marginal zone lymphoma and 19 as pseudolymphomatous folliculitis. Hum Pathol. May 2005;36(5):505-11. [Medline].

  14. Braun-Falco O, Plewig G, Wolff HH. Pseudolymphomas of the skin. Dermatology. 1984;1074-5.

  15. Calnan CD. Lymphocytic infiltration of the skin (Jessner). Br J Dermatol. May 1957;69(5):169-73. [Medline].

  16. Gottlieb M, Winkelman RK. Lymphocytic infiltration of the skin. Arch Dermatol. 1962;68:626.

  17. Kuhn A, Richter-Hintz D, Oslislo C, Ruzicka T, Megahed M, Lehmann P. Lupus erythematosus tumidus--a neglected subset of cutaneous Lupus erythematosus: report of 40 cases. Arch Dermatol. Aug 2000;136(8):1033-41. [Medline].

  18. Lever WF, Lever GS. Connective Tissue Diseases. In: Histopathology of the Skin. Baltimore, Md: Lippincott Williams & Wilkins; 1990:505-06.

  19. Lipsker D, Mitschler A, Grosshans E, Cribier B.Could Jessner's lymphocytic infiltrate of the skin be a dermal variant of lupus erythematosus? An analysis of 210 cases.Dermatology. 2006;213(1):15-22 [database online].

  20. Mackie RM. Cutaneous Lymphomas and Lymphocytic Infiltrates. In: Textbook of Dermatology. Vol. 3. London, England: Blackwell Science; 1998:2400-01.

  21. Nolden S, Casper C, Kuhn A, Petereit HF. Jessner-Kanof lymphocytic infiltration of the skin associated with glatiramer acetate. Mult Scler. Apr 2005;11(2):245-8. [Medline].

  22. Rijlaarsdam JU, Nieboer C, de Vries E, Willemze R. Characterization of the dermal infiltrates in Jessner's lymphocytic infiltrate of the skin, polymorphous light eruption and cutaneous lupus erythematosus: differential diagnostic and pathogenetic aspects. J Cutan Pathol. Feb 1990;17(1):2-8. [Medline].

  23. Toonstra J, Wildschut A, Boer J, Smeenk G, Willemze R, van der Putte SC, et al. Jessner's lymphocytic infiltration of the skin. A clinical study of 100 patients. Arch Dermatol. Nov 1989;125(11):1525-30. [Medline].

  24. Willemze R, Dijkstra A, Meijer CJ. Lymphocytic infiltration of the skin (Jessner): a T-cell lymphoproliferative disease. Br J Dermatol. May 1984;110(5):523-9. [Medline].

  25. Wolf M. Lymphocytic infiltration of the face. Arch Dermatol. 1957;75:136.

 
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