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Jessner Lymphocytic Infiltration of the Skin Treatment & Management

  • Author: Kara Melissa T Torres, MD, DPDS; Chief Editor: William D James, MD  more...
 
Updated: Jan 12, 2015
 

Medical Care

Prognosis is good because lymphocytic infiltration of the skin may resolve spontaneously. It may require no treatment, but some patients benefit from cosmetic camouflage, photoprotection, excision of small lesions, topical steroids, intralesional steroids, oral hydroxychloroquine, systemic steroids, cryotherapy, methotrexate,[22] thalidomide,[23] and/or oral auranofin.[24, 25, 26]

In 2009, Borges da Costa et al treated one patient with a pulsed-dye laser using a 10-mm spot, a fluence of 7 J/cm2, and a single pulse of 0.5 msg. Complete clearing of all lesions was observed after only one treatment, without any adverse effects.[27] The value of pulsed dye laser as a possible first-line treatment for LIS was again analysed in 2010.[28] In 3 of 5 patients, a single treatment session with 6-8 J/cm2 showed complete clearing of the lesions. There was no recurrence in the 3 patients at 4-8 years of follow-up.

Park et al reported a case of a patient with lymphocytic infiltration of the skin, refractory to usual treatments, who was treated with photodynamic therapy (PDT). Lesions showed marked improvement after 2 sessions of methyl 5-aminolevulinic acid PDT.[29] Another option for refractory disease is oral methotrexate at 15 mg/wk for 4 months.[22] There was no recurrence after 2 years of observation.

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Surgical Care

Excision of solitary small lesions may be possible.

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Consultations

A dermatologist may be consulted to suggest options for cosmetic camouflage.

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Diet

No dietary recommendations are currently proposed.

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Activity

No specific activity limits or exercises are recommended. Photoprotection is needed for all patients.

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Contributor Information and Disclosures
Author

Kara Melissa T Torres, MD, DPDS Visiting Research Fellow, Ackerman Academy of Dermatopathology

Kara Melissa T Torres, MD, DPDS is a member of the following medical societies: Philippine Dermatological Society

Disclosure: Nothing to disclose.

Coauthor(s)

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

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

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster 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, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

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, Association of Professors of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

Mohsin Ali, MBBS, MRCP, MRCPI Consulting Staff, Department of Dermatology, Amersham General Hospital, UK

Disclosure: Nothing to disclose.

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.

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.

Nicole Sakka, MBBS Foundation Year 2, Royal Liverpool and Broadgreen University Hospital, Liverpool, UK

Disclosure: Nothing to disclose.

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

Disclosure: Nothing to disclose.

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.

References
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  2. 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.

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  20. 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. 1990 Feb. 17(1):2-8. [Medline].

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

  22. 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.

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

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

  26. Ordi-Ros J, Cosiglio FJ. [Current therapeutic indications of thalidomide and lenalidomide]. Med Clin (Barc). 2014 Apr 22. 142(8):360-4. [Medline].

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  29. Park KY, Kim HK, Li K, Kim BJ, Seo SJ, Kim MN, et al. Photodynamic therapy: new treatment for refractory lymphocytic infiltration of the skin. Clin Exp Dermatol. 2012 Feb 2. [Medline].

 
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Jessner lymphocytic infiltration of the skin.
Jessner lymphocytic infiltration of the skin.
 
 
 
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