Jessner Lymphocytic Infiltration of the Skin Treatment & Management
- Author: Kara Melissa T Torres, MD, DPDS; Chief Editor: William D James, MD more...
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, thalidomide, 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. The value of pulsed dye laser as a possible first-line treatment for LIS was again analysed in 2010. 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. Another option for refractory disease is oral methotrexate at 15 mg/wk for 4 months. There was no recurrence after 2 years of observation.
Excision of solitary small lesions may be possible.
A dermatologist may be consulted to suggest options for cosmetic camouflage.
No dietary recommendations are currently proposed.
No specific activity limits or exercises are recommended. Photoprotection is needed for all patients.
Jessner M, Kanof NB. Lymphocytic infiltration of the skin. Arch Dermatol. 1953. 68:447-9.
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.
James WD, Berger TG, Elston DE, eds. Clinical Dermatology. Andrews' Diseases of the Skin. 10th ed. Elsevier Saunders; 2006.
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].
Ziemer M, Eisendle K, Müller H, Zelger B. Lymphocytic infiltration of the skin (Jessner-Kanof) but not reticular erythematous mucinosis occasionally represents clinical manifestations of Borrelia-associated pseudolymphoma. Br J Dermatol. 2009 Sep. 161(3):583-90. [Medline].
Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Elsevier Saunders; 2012.
Braddock SW, Kay HD, Maennle D, McDonald TL, Pirruccello SJ, Masih A, et al. Clinical and immunologic studies in reticular erythematous mucinosis and Jessner's lymphocytic infiltrate of skin. J Am Acad Dermatol. 1993 May. 28(5 Pt 1):691-5. [Medline].
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. 2001 Feb. 144(2):292-6. [Medline].
Rémy-Leroux V, Léonard F, Lambert D, Wechsler J, Cribier B, Thomas P, et al. Comparison of histopathologic-clinical characteristics of Jessner's lymphocytic infiltration of the skin and lupus erythematosus tumidus: Multicenter study of 46 cases. J Am Acad Dermatol. 2008 Feb. 58(2):217-23. [Medline].
Tomasini D, Mentzel T, Hantschke M, Cerri A, Paredes B, Rütten A, et al. Plasmacytoid dendritic cells: an overview of their presence and distribution in different inflammatory skin diseases, with special emphasis on Jessner's lymphocytic infiltrate of the skin and cutaneous lupus erythematosus. J Cutan Pathol. 2010 Nov. 37(11):1132-9. [Medline].
Schepis C, Lentini M, Siragusa M, Batolo D. ACE-inhibitor-induced drug eruption resembling lymphocytic infiltration (of Jessner-Kanof) and Lupus erythematosus tumidus. Dermatology. 2004. 208(4):354-5. [Medline].
Nolden S, Casper C, Kuhn A, Petereit HF. Jessner-Kanof lymphocytic infiltration of the skin associated with glatiramer acetate. Mult Scler. 2005 Apr. 11(2):245-8. [Medline].
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. 2002 Dec. 129(12):1370-3. [Medline].
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].
Wolf M. Lymphocytic infiltration of the face. Arch Dermatol. 1957. 75:136.
Bahillo-Monné C, Heras-Mendaza F, Casado-Fariñas I, Gatica-Ortega M, Conde-Salazar L. Jessner's lymphocytic infiltrate as a Koebner response to patch test. Contact Dermatitis. 2007 Sep. 57(3):197-9. [Medline].
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. 1987 Aug. 14(4):198-201. [Medline].
Kunz M, Henseleit-Walter U, Sorg C, Kolde G. Macrophage marker 27E10 on human keratinocytes helps to differentiate discoid lupus erythematosus and Jessner's lymphocytic infiltration of the skin. Eur J Dermatol. 1999 Mar. 9(2):107-10. [Medline].
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].
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].
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.
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].
Hafejee A, Winhoven S, Coulson IH. Jessner's lymphocytic infiltrate responding to oral auranofin. J Dermatolog Treat. 2004 Sep. 15(5):331-2. [Medline].
Green CM.Clin Exp Dermatol.Successful treatment of Jessner's lymphocytic infiltrate with auranofin.Clin Exp Dermatol. 2008 Jan;33(1):108-9.
Ordi-Ros J, Cosiglio FJ. [Current therapeutic indications of thalidomide and lenalidomide]. Med Clin (Barc). 2014 Apr 22. 142(8):360-4. [Medline].
Borges da Costa J, Boixeda P, Moreno C. Pulsed-dye laser treatment of Jessner lymphocytic infiltration of the skin. J Eur Acad Dermatol Venereol. 2008 Sep 1. [Medline].
Michel JL, Perrin D. [Pulsed dye laser treatment for Jessner's lymphocytic infiltration of the skin]. Ann Dermatol Venereol. 2010 Dec. 137(12):803-7. [Medline].
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].