Acral lymphomatoid papulosis: Report of five cases, differential diagnosis, and review

J Cutan Pathol. 2021 May;48(5):650-658. doi: 10.1111/cup.13929. Epub 2021 Jan 13.

Abstract

Acral lymphomatoid papulosis (a-LyP) is a rare clinical variant of LyP whose diagnosis may be challenging. A case series of a-LyP was studied clinically, histopathologically, immunohistochemically, and from molecular point of view. Including ours, 25 cases of a-LyP have so far been reported. Clinically, a-LyP may present as acral involvement exclusively, in combination with mucosal lesions, (in itself a rare presentation), or in association with conventional LyP. The age of presentation was slightly higher than that of conventional LyP (55 vs 45 years) and a male predominance has been observed, as usually reported. Histopathologically, no morphological differences exclusively from conventional LyP were observed. LyP types A and E were the main variants. We describe for the first time one case of type D a-LyP. Acral LyP is a rare entity and correct diagnosis can only be reached with clinical and histopathological correlation, to avoid aggressive treatment of this indolent lymphoproliferative disorder.

Keywords: CD30+ lymphoproliferative disorder; localized lymphomatoid papulosis; lymphomatoid papulosis; mucosal lymphomatoid papulosis; primary cutaneous lymphoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunohistochemistry / methods
  • Ki-1 Antigen / metabolism*
  • Lymphomatoid Papulosis / diagnosis
  • Lymphomatoid Papulosis / metabolism
  • Lymphomatoid Papulosis / pathology*
  • Lymphoproliferative Disorders / metabolism
  • Lymphoproliferative Disorders / pathology*
  • Male
  • Middle Aged
  • Skin Neoplasms / pathology*

Substances

  • Ki-1 Antigen