Jessner Lymphocytic Infiltration of the Skin

Excerpt

Jessner lymphocytic infiltration of the skin (JLIS) is the term used to describe a rare, benign cutaneous condition characterized by papular or plaque-like eruptions that commonly involve sun-exposed areas such as face, neck, and trunk. The eruptions are erythematous, non-scaly, and can also be annular. This disease has an indolent course, lasting weeks to months, and as the eruptions expand peripherally, they can sometimes exhibit central clearing or healing. The eruptions then clear spontaneously, or with the aid of medications, without sequelae but frequently recur. The lesions are usually asymptomatic. However, some patients have complained of burning and pruritus.

This disease is diagnosed by biopsy revealing perivascular and periadnexal clusters of plasmacytoid monocytes within the dermis, sometimes extending into the subcutaneous tissue. These cells, also known as plasmacytoid dendritic cells, play a vital role in the induction of autoimmune diseases and other skin diseases. While their presence, along with an inappropriate CD8+ T cell predominant lymphoid infiltrate, provides a definitive diagnosis of JLIS, the cause of this disorder remains unknown. However, there remains the possibility of hereditary and autoimmune components.JLIS, also known as benign lymphocytic infiltration of the skin, Jessner-Kanof syndrome, and benign chronic T-cell infiltrative disease, was first described in 1953 by Max Jessner and Norman Kanof.

In 1969, the disease was included under the umbrella term cutaneous lymphoid hyperplasia along with lymphocytoma cutis and malignant lymphomas used to encompass skin diseases with lymphocytic infiltrates. There is still debate about whether this disease is a unique entity or part of a spectrum of cutaneous diseases, including discoid lupus erythematosus, polymorphous light eruption, and possibly malignant lymphoma. However, there is no conclusive evidence of progression to any of the diseases mentioned above, although there are case reports of patients with concurrent manifestations.