Cutaneous Pseudolymphoma Treatment & Management

Updated: May 17, 2016
  • Author: Christine J Ko, MD; Chief Editor: William D James, MD  more...
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Treatment

Approach Considerations

When the offending agent is known, its removal results in resolution of the cutaneous pseudolymphoma. Cases of cutaneous pseudolymphoma documented to occur as a result of infection should be appropriately treated. In idiopathic cases of cutaneous pseudolymphoma, treatment is not mandatory. Cures may be effected via surgical removal, cryosurgery, or local irradiation. Some reports have noted a response to topical or injected corticosteroids and topical immunomodulators such as tacrolimus. [26]

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Medical Care

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

When the diagnosis of pseudolymphoma is suspected, all implicated drugs should be discontinued. Because lesions are typically asymptomatic, no additional medical treatment is required. A short course of topical or intralesional steroids may be attempted to hasten regression. The time course for lesion regression can range from 1-3 months. Careful follow up is prudent because a nonresolving lesion should prompt concern for a malignant process.

Case reports have suggested the efficacy of imiquimod. [27] Antibiotics have been reported helpful in some reported cases associated with Borrelia infection. [3] Subcutaneous injection of interferon-alfa has also cleared cutaneous pseudolymphoma. [28, 29] Photodynamic therapy has also been used. [30]

The Medscape Skin Cancer Resource Center may be of interest.

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Surgical Care

In cutaneous pseudolymphoma, simple excision of the involved site can be curative in some cases.

Cryosurgery may be effective in some cases of lymphocytoma cutis.

Lesions that interfere with function or are cosmetically undesirable may be surgically removed. No recurrence of excised lesions has been seen after withdrawal of the causative drugs. In cases of incomplete regression, external radiation therapy has also been reported to be successful. Successful treatment of tattoo pigment–induced pseudolymphoma with fractional resurfacing and subsequent Q-switched Nd:YAG 532-nm laser treatments has been reported. [31]

The Medscape Dermatologic Surgery Resource Center may be of interest.

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Long-Term Monitoring

Because malignant lymphomas have been reported following clearance of pseudolymphoma, patients should be continually monitored for constitutional signs of lymphoma.

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