Jessner Lymphocytic Infiltration of the Skin Treatment & Management

Updated: Dec 13, 2017
  • Author: Kara Melissa Torres Culala, MD; Chief Editor: William D James, MD  more...
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Treatment

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, [24] thalidomide, [25] and/or oral auranofin. [26, 27, 28]

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. [29] The value of pulsed dye laser as a possible first-line treatment for LIS was again analysed in 2010. [30] 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. [31] Another option for refractory disease is oral methotrexate at 15 mg/wk for 4 months. [24] 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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Prevention

Prevention is not possible because the etiology of lymphocytic infiltration of the skin is unknown. Sun avoidance and photoprotection are strongly recommended in all cases with or without a history of photo-aggravation because lymphocytic infiltration of the skin is very likely a photosensitive disorder.

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Long-Term Monitoring

Regular follow-up is required to monitor for the occurrence of steroid atrophy if potent topical steroids are used.

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