Lymphomatoid Papulosis Differential Diagnoses

  • Author: John A Zic; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 24, 2012
 
 
 
Contributor Information and Disclosures
Author

John A Zic  MD, Associate Professor of Medicine/Dermatology, Director, VU Cutaneous Lymphoma Clinic, Vanderbilt University School of Medicine

John A Zic is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Gregory J Raugi, MD, PhD  Professor, Department of Internal Medicine, Division of Dermatology, University of Washington at Seattle School of Medicine; Chief, Dermatology Section, Primary and Specialty Care Service, Veterans Administration Medical Center of Seattle

Gregory J Raugi, MD, PhD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Michael J Wells, MD  Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, 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.

Joel M Gelfand, MD, MSCE  Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

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

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous Chief Editor, William D. James, MD, and previous author, Kristina Collins, MD, to the development and writing of this article.

References
  1. Macaulay WL. Lymphomatoid papulosis. A continuing self-healing eruption, clinically benign--histologically malignant. Arch Dermatol. Jan 1968;97(1):23-30. [Medline].

  2. Slater DN. The new World Health Organization-European Organization for Research and Treatment of Cancer classification for cutaneous lymphomas: a practical marriage of two giants. Br J Dermatol. Nov 2005;153(5):874-80. [Medline].

  3. Willemze R, Meijer CJ. Classification of cutaneous T-cell lymphoma: from Alibert to WHO-EORTC. J Cutan Pathol. Feb 2006;33 Suppl 1:18-26. [Medline].

  4. Willemze R, Jaffe ES, Burg G, et al. WHO-EORTC classification for cutaneous lymphomas. Blood. May 15 2005;105(10):3768-85. [Medline].

  5. de Souza A, El-Azhary RA, Camilleri MJ, Wada DA, Appert DL, Gibson LE. In search of prognostic indicators for lymphomatoid papulosis: A retrospective study of 123 patients. J Am Acad Dermatol. Oct 7 2011;[Medline].

  6. Rassidakis GZ, Thomaides A, Atwell C, et al. JunB expression is a common feature of CD30+ lymphomas and lymphomatoid papulosis. Mod Pathol. Oct 2005;18(10):1365-70. [Medline].

  7. Clarke LE, Bayerl MG, Bruggeman RD, et al. Death receptor apoptosis signaling mediated by FADD in CD30-positive lymphoproliferative disorders involving the skin. Am J Surg Pathol. Apr 2005;29(4):452-9. [Medline].

  8. Pujol RM, Muret MP, Bergua P, Bordes R, Alomar A. Oral involvement in lymphomatoid papulosis. Report of two cases and review of the literature. Dermatology. 2005;210(1):53-7. [Medline].

  9. de-Misa RF, Garcia M, Dorta S, et al. Solitary oral ulceration as the first appearance of lymphomatoid papulosis: a diagnostic challenge. Clin Exp Dermatol. May 21 2009;[Medline].

  10. Wang HH, Lach L, Kadin ME. Epidemiology of lymphomatoid papulosis. Cancer. Dec 15 1992;70(12):2951-7. [Medline].

  11. Moura FN, Thomas L, Balme B, Dalle S. Dermoscopy of lymphomatoid papulosis. Arch Dermatol. Aug 2009;145(8):966-7. [Medline].

  12. Kim YC, Yang WI, Lee MG, et al. Epstein-Barr virus in CD30 anaplastic large cell lymphoma involving the skin and lymphomatoid papulosis in South Korea. Int J Dermatol. Nov 2006;45(11):1312-6. [Medline].

  13. Vonderheid EC, Kadin ME, Gocke CD. Lymphomatoid papulosis followed by pityriasis lichenoides: a common pathogenesis?. Am J Dermatopathol. Dec 2011;33(8):835-40. [Medline].

  14. Leo AM, Ermolovich T. Lymphomatoid papulosis while on efalizumab. J Am Acad Dermatol. Sep 2009;61(3):540-1. [Medline].

  15. Talsania N, O'Toole EA. Severe hypersensitivity reaction to minocycline in association with lymphomatoid papulosis. Clin Exp Dermatol. Oct 2009;34(7):e397-8. [Medline].

  16. KIM SK, KIM YC. Lymphomatoid papulosis after allogenic stem cell transplantation. Eur J Dermatol. Sep-Oct 2009;19(5):520-1. [Medline].

  17. de Souza A, Gibson LE, Wada DA, et al. Resolution of CD8+ lymphomatoid papulosis after surgical excision of the type AB-thymoma. Am J Dermatopathol. Jul 2009;31(5):475-9. [Medline].

  18. El Shabrawi-Caelen L, Kerl H, Cerroni L. Lymphomatoid papulosis: reappraisal of clinicopathologic presentation and classification into subtypes A, B, and C. Arch Dermatol. Apr 2004;140(4):441-7. [Medline].

  19. Willemze R, Beljaards RC. Spectrum of primary cutaneous CD30 (Ki-1)-positive lymphoproliferative disorders. A proposal for classification and guidelines for management and treatment. J Am Acad Dermatol. Jun 1993;28(6):973-80. [Medline].

  20. Liu HL, Hoppe RT, Kohler S, Harvell JD, Reddy S, Kim YH. CD30+ cutaneous lymphoproliferative disorders: the Stanford experience in lymphomatoid papulosis and primary cutaneous anaplastic large cell lymphoma. J Am Acad Dermatol. Dec 2003;49(6):1049-58. [Medline].

  21. Bergstrom JS, Jaworsky C. Topical methotrexate for lymphomatoid papulosis. J Am Acad Dermatol. Nov 2003;49(5):937-9. [Medline].

  22. Vonderheid EC, Sajjadian A, Kadin ME. Methotrexate is effective therapy for lymphomatoid papulosis and other primary cutaneous CD30-positive lymphoproliferative disorders. J Am Acad Dermatol. Mar 1996;34(3):470-81. [Medline].

  23. Jain N, Gutte R, Jadhav P, Khopkar U. Granulomatous and eccrinotropic lymphomatoid papulosis. Indian J Dermatol Venereol Leprol. Jan 2012;78(1):82-4. [Medline].

  24. Yip L, Darling S, Orchard D. Lymphomatoid papulosis in children: experience of five cases and the treatment efficacy of methotrexate. Australas J Dermatol. Nov 2011;52(4):279-83. [Medline].

  25. Hoetzenecker W, Guenova E, Hoetzenecker K, Yazdi A, Röcken M, Berneburg M. Successful treatment of recalcitrant lymphomatoid papulosis in a child with PUVA-bath photochemotherapy. Eur J Dermatol. Nov-Dec 2009;19(6):646-7. [Medline].

  26. Hughes PS. Treatment of lymphomatoid papulosis with imiquimod 5% cream. J Am Acad Dermatol. Mar 2006;54(3):546-7. [Medline].

  27. Kontos AP, Kerr HA, Malick F, Fivenson DP, Lim HW, Wong HK. 308-nm excimer laser for the treatment of lymphomatoid papulosis and stage IA mycosis fungoides. Photodermatol Photoimmunol Photomed. Jun 2006;22(3):168-71. [Medline].

  28. Rodrigues M, McCormack C, Yap LM, et al. Successful treatment of lymphomatoid papulosis with photodynamic therapy. Australas J Dermatol. May 2009;50(2):129-32. [Medline].

  29. Beljaards RC, Willemze R. The prognosis of patients with lymphomatoid papulosis associated with malignant lymphomas. Br J Dermatol. Jun 1992;126(6):596-602. [Medline].

  30. Kempf W, Levi E, Kamarashev J, et al. Fascin expression in CD30-positive cutaneous lymphoproliferative disorders. J Cutan Pathol. May 2002;29(5):295-300. [Medline].

  31. Cabanillas F, Armitage J, Pugh WC, Weisenburger D, Duvic M. Lymphomatoid papulosis: a T-cell dyscrasia with a propensity to transform into malignant lymphoma. Ann Intern Med. Feb 1 1995;122(3):210-7. [Medline].

  32. Demierre MF, Goldberg LJ, Kadin ME, Koh HK. Is it lymphoma or lymphomatoid papulosis?. J Am Acad Dermatol. May 1997;36(5 Pt 1):765-72.

  33. el-Azhary RA, Gibson LE, Kurtin PJ, Pittelkow MR, Muller SA. Lymphomatoid papulosis: a clinical and histopathologic review of 53 cases with leukocyte immunophenotyping, DNA flow cytometry, and T-cell receptor gene rearrangement studies. J Am Acad Dermatol. Feb 1994;30(2 Pt 1):210-8. [Medline].

  34. Flann S, Orchard GE, Wain EM, Russell-Jones R. Three cases of lymphomatoid papulosis with a CD56+ immunophenotype. J Am Acad Dermatol. Nov 2006;55(5):903-6. [Medline].

  35. Franchina M, Kadin ME, Abraham LJ. Polymorphism of the CD30 promoter microsatellite repressive element is associated with development of primary cutaneous lymphoproliferative disorders. Cancer Epidemiol Biomarkers Prev. May 2005;14(5):1322-5. [Medline].

  36. Gellrich S, Wernicke M, Wilks A, et al. The cell infiltrate in lymphomatoid papulosis comprises a mixture of polyclonal large atypical cells (CD30-positive) and smaller monoclonal T cells (CD30-negative). J Invest Dermatol. Mar 2004;122(3):859-61. [Medline].

  37. Greisser J, Doebbeling U, Roos M, et al. Apoptosis in CD30-positive lymphoproliferative disorders of the skin. Exp Dermatol. May 2005;14(5):380-5. [Medline].

  38. Gruber R, Sepp NT, Fritsch PO, Schmuth M. Prognosis of lymphomatoid papulosis. Oncologist. Sep 2006;11(8):955-7; author reply 957. [Medline].

  39. Kadin ME. Pathobiology of CD30+ cutaneous T-cell lymphomas. J Cutan Pathol. Feb 2006;33 Suppl 1:10-7. [Medline].

  40. Kempf W. CD30+ lymphoproliferative disorders: histopathology, differential diagnosis, new variants, and simulators. J Cutan Pathol. Feb 2006;33 Suppl 1:58-70. [Medline].

  41. Liu HL, Hoppe RT, Kohler S, Harvell JD, Reddy S, Kim YH. CD30+ cutaneous lymphoproliferative disorders: the Stanford experience in lymphomatoid papulosis and primary cutaneous anaplastic large cell lymphoma. J Am Acad Dermatol. Dec 2003;49(6):1049-58. [Medline].

  42. Magro CM, Crowson AN, Morrison C, Merati K, Porcu P, Wright ED. CD8+ lymphomatoid papulosis and its differential diagnosis. Am J Clin Pathol. Apr 2006;125(4):490-501. [Medline].

  43. Schultz JC, Granados S, Vonderheid EC, Hwang ST. T-cell clonality of peripheral blood lymphocytes in patients with lymphomatoid papulosis. J Am Acad Dermatol. Jul 2005;53(1):152-5. [Medline].

  44. Wang HH, Lach L, Kadin ME. Epidemiology of lymphomatoid papulosis. Cancer. Dec 15 1992;70(12):2951-7. [Medline].

  45. Wood GS, Crooks CF, Uluer AZ. Lymphomatoid papulosis and associated cutaneous lymphoproliferative disorders exhibit a common clonal origin. J Invest Dermatol. Jul 1995;105(1):51-5. [Medline].

  46. Yagi H, Seo N, Ohshima A, et al. Chemokine receptor expression in cutaneous T cell and NK/T-cell lymphomas: immunohistochemical staining and in vitro chemotactic assay. Am J Surg Pathol. Sep 2006;30(9):1111-9. [Medline].

  47. Yamaguchi T, Ohshima K, Karube K, et al. Expression of chemokines and chemokine receptors in cutaneous CD30+ lymphoproliferative disorders. Br J Dermatol. May 2006;154(5):904-9. [Medline].

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Lymphomatoid papulosis type C on the upper back of a 65-year-old woman with waxing and waning papulonodular eruptions for almost 10 years. The eruption was suppressed completely using methotrexate.
Crusted ulcerated papule of lymphomatoid papulosis on the left hip of a 47-year-old woman with a longer than 20-year history of recurrent papulonodular eruption with spontaneous resolution.
Large indurated plaques of anaplastic large cell lymphoma of 2-months' duration on the left lateral thigh of a 57-year-old man with a 5-year history of lymphomatoid papulosis. The lymphomatoid papulosis skin lesions (not pictured) were rarely larger than 6 mm.
Lymphomatoid papulosis type A showing a cluster of pink papules and 2 crusted papules that resolved spontaneously in the left axilla of a 68-year-old man. The first symptoms developed in the popliteal fossa 8 years before erupting into more widespread papules 10 months before this photograph was taken.
 
 
 
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