eMedicine Specialties > Dermatology > Lymphoma and Related Processes

Pseudolymphoma, Cutaneous: Treatment & Medication

Author: Christine J Ko, MD, Assistant Professor, Departments of Dermatology and Pathology, Yale University School of Medicine
Coauthor(s): Jon H Meyerle, MD, Assistant Professor, Department of Dermatology, Johns Hopkins University School of Medicine; Consulting Staff, Laboratory Director, Department of Dermatology, Walter Reed Army Medical Center and National Naval Medical Center; Earl J Glusac, MD, Professor, Departments of Pathology and Dermatology, Yale University School of Medicine
Contributor Information and Disclosures

Updated: Oct 22, 2008

Treatment

Medical Care

When the offending agent is known, its removal results in resolution. Cases documented to occur as a result of infection should be appropriately treated. In idiopathic cases, treatment is not mandatory. Cures may be affected via surgical removal, cryosurgery, or local irradiation. Some reports have noted a response to topical or injected corticosteroids and topical immunomodulators such as tacrolimus.

Patients with presumed pseudolymphoma in which the possibility of lymphoma cannot be excluded should be evaluated for the possibility of concurrent extracutaneous disease and followed for possible emergence of lymphoma.

Surgical Care

Simple excision of the involved site can be curative in some cases.

Medication

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.

Corticosteroids

These agents have anti-inflammatory properties and cause profound and varied metabolic effects. In addition, these agents modify the body's immune response to diverse stimuli.


Hydrocortisone valerate 0.2% (Westcort)

Adrenocorticosteroid derivative suitable for application to skin or external mucous membranes. Has mineralocorticoid and glucocorticoid effects resulting in anti-inflammatory activity. Treats inflammatory dermatosis responsive to steroids. Decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing capillary permeability.

Adult

Apply a thin film to affected area bid until favorable response

Pediatric

Apply as in adults

Documented hypersensitivity; viral, fungal, and bacterial skin infections

Pregnancy

C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus

Precautions

Can cause atrophy of the skin with prolonged application; systemic absorption of topical steroids has produced HPA-axis suppression, glycosuria, hyperglycemia, and symptoms of Cushing syndrome in some patients, especially with prolonged use over wide body surface areas


Betamethasone 0.05% Cream or Ointment (Diprolene, Betatrex)

For inflammatory dermatosis responsive to steroids. Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reversing capillary permeability.

Adult

Apply thin film bid for up to 2 wk

Pediatric

<12 years: Not recommended

Hypersensitivity; viral, fungal, and bacterial skin infections

Pregnancy

C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus

Precautions

Can cause atrophy of the skin with prolonged application; systemic absorption of topical steroids has produced HPA-axis suppression, glycosuria, hyperglycemia, and symptoms of Cushing syndrome in some patients, especially with prolonged use over wide body surface areas


Clobetasol (Temovate)

Class I superpotent topical steroid; suppresses mitosis and increases synthesis of proteins that decrease inflammation and cause vasoconstriction.

Adult

Apply bid for up to 2 wk; not to exceed 50 g/wk

Pediatric

<12 years: Not recommended

Documented hypersensitivity; viral or fungal skin infections

Pregnancy

C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus

Precautions

Can cause atrophy of the skin with prolonged application; systemic absorption of topical steroids has produced HPA-axis suppression, glycosuria, hyperglycemia, and symptoms of Cushing syndrome in some patients, especially with prolonged use over wide body surface areas


Fluocinonide cream or ointment 0.05% (Fluonex, Lidex)

High-potency topical corticosteroid that inhibits cell proliferation; is immunosuppressive and anti-inflammatory.

Adult

Apply sparingly bid for up to 2 wk

Pediatric

Administer as in adults

Documented hypersensitivity; fungal, viral, or bacterial skin infections

Pregnancy

C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus

Precautions

Can cause atrophy of the skin with prolonged application; systemic absorption of topical steroids has produced HPA-axis suppression, glycosuria, hyperglycemia, and symptoms of Cushing syndrome in some patients, especially with prolonged use over wide body surface areas

More on Pseudolymphoma, Cutaneous

Overview: Pseudolymphoma, Cutaneous
Differential Diagnoses & Workup: Pseudolymphoma, Cutaneous
Treatment & Medication: Pseudolymphoma, Cutaneous
Follow-up: Pseudolymphoma, Cutaneous
Multimedia: Pseudolymphoma, Cutaneous
References
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References

  1. Brodell RT, Santa Cruz DJ. Cutaneous pseudolymphomas. Dermatol Clin. Oct 1985;3(4):719-34. [Medline].

  2. Choi TS, Doh KS, Kim SH, Jang MS, Suh KS, Kim ST. Clinicopathological and genotypic aspects of anticonvulsant-induced pseudolymphoma syndrome. Br J Dermatol. Apr 2003;148(4):730-6. [Medline].

  3. Albrecht J, Fine LA, Piette W. Drug-associated lymphoma and pseudolymphoma: recognition and management. Dermatol Clin. Apr 2007;25(2):233-44, vii. [Medline].

  4. Maubec E, Pinquier L, Viguier M, Caux F, Amsler E, Aractingi S, et al. Vaccination-induced cutaneous pseudolymphoma. J Am Acad Dermatol. Apr 2005;52(4):623-9. [Medline].

  5. Braun RP, French LE, Feldmann R, Chavaz P, Saurat JH. Cutaneous pseudolymphoma, lymphomatoid contact dermatitis type, as an unusual cause of symmetrical upper eyelid nodules. Br J Dermatol. Aug 2000;143(2):411-4. [Medline].

  6. Gutermuth J, Audring H, Roseeuw D. Disseminated cutaneous B-cell lymphoma mimicking pseudolymphoma over a period of six years. Am J Dermatopathol. Jun 2004;26(3):225-9. [Medline].

  7. Kempf W, Dummer R, Burg G. Approach to lymphoproliferative infiltrates of the skin. The difficult lesions. Am J Clin Pathol. Jan 1999;111(1 Suppl 1):S84-93. [Medline].

  8. Burg G, Kerl H, Schmoeckel C. Differentiation between malignant B-cell lymphomas and pseudolymphomas of the skin. J Dermatol Surg Oncol. Apr 1984;10(4):271-5. [Medline].

  9. Geerts ML, Kaiserling E. A morphologic study of lymphadenosis benigna cutis. Dermatologica. 1985;170(3):121-7. [Medline].

  10. Ploysangam T, Breneman DL, Mutasim DF. Cutaneous pseudolymphomas. J Am Acad Dermatol. Jun 1998;38(6 Pt 1):877-95; quiz 896-7. [Medline].

  11. Connors RC, Ackerman AB. Histologic pseudomalignancies of the skin. Arch Dermatol. Dec 1976;112(12):1767-80. [Medline].

  12. Rijlaarsdam U, Willemze R. Cutaneous pseudo-T-cell lymphomas. Semin Diagn Pathol. May 1991;8(2):102-8. [Medline].

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Further Reading

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Keywords

lymphocytoma cutis, cutaneous lymphomatous hyperplasia, lymphadenosis benigna cutis, cutaneous lymphoplasia

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Contributor Information and Disclosures

Author

Christine J Ko, MD, Assistant Professor, Departments of Dermatology and Pathology, Yale University School of Medicine
Christine J Ko, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and International Society of Dermatopathology
Disclosure: Nothing to disclose.

Coauthor(s)

Jon H Meyerle, MD, Assistant Professor, Department of Dermatology, Johns Hopkins University School of Medicine; Consulting Staff, Laboratory Director, Department of Dermatology, Walter Reed Army Medical Center and National Naval Medical Center
Jon H Meyerle, MD is a member of the following medical societies: American Academy of Dermatology and Sigma Xi
Disclosure: Nothing to disclose.

Earl J Glusac, MD, Professor, Departments of Pathology and Dermatology, Yale University School of Medicine
Earl J Glusac, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

Medical Editor

Günter Burg, MD, Professor and Chairman Emeritus, Department of Dermatology, University of Zürich School of Medicine; Delegate of The Foundation for Modern Teaching and Learning in Medicine Faculty of Medicine, University of Zürich, Switzerland
Günter Burg, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, International Society for Dermatologic Surgery, North American Clinical Dermatologic Society, and Pacific Dermatologic Association
Disclosure: Nothing to disclose.

Pharmacy Editor

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.

Managing Editor

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.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
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.

 
 
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