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Caro-Chang LA, Fung MA. The role of eosinophils in the differential diagnosis of inflammatory skin diseases. Hum Pathol 2023; 140:101-128. [PMID: 37003367 DOI: 10.1016/j.humpath.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023]
Abstract
Eosinophils are known to be present in inflammatory skin diseases, but their diagnostic utility is not well established. Upon review of the published status of lesional eosinophils, several categories were identified. 1) Lesional eosinophils highly characteristic such that, in their absence, the pathologist may question the diagnosis. These include arthropod bite reactions and scabies, urticarial dermatitis, and other eosinophilic dermatoses. 2) Lesional eosinophils rare or absent, such that, in their presence, the pathologist may question the diagnosis. These include pityriasis lichenoides, graft versus host disease, and connective tissue disorders. 3) Lesional eosinophils variable and, while in some cases expected, are not required for diagnosis. These include drug reactions, atopic dermatitis and allergic contact dermatitis. 4) Lesional eosinophils variable and not expected but may be seen to a limited extent. These include lichen planus and psoriasis.
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2
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Fernandez-Flores A, Cassarino D. CD30 in Cutaneous Pathology. Am J Dermatopathol 2023; 45:593-607. [PMID: 37625801 DOI: 10.1097/dad.0000000000002422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
ABSTRACT The discovery of CD30 as a diagnostic marker was essential in the identification of not only some lymphomas but also many other solid tumors and benign reactive conditions. Many CD30+ cutaneous disorders and tumors have been categorized since the identification of the marker. With the design of targeted therapies against CD30+ tumoral cells, the interest in CD30 determination was not only diagnostic but also mainly therapeutic. In this article, we explore the historical aspects of the discovery of CD30 and examine the main CD30-related cutaneous pathology, susceptible of anti-CD30 modern treatments.
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Affiliation(s)
- Angel Fernandez-Flores
- Dermatopathologist, Department of Histopathology, University Hospital El Bierzo, Ponferrada, Spain
- Department of Cellular Pathology, Hospital de la Reina, Ponferrada, Spain
- Research Department, Institute for Biomedical Research of a Coruña (INIBIC), University of a Coruña (UDC), A Coruña, Spain; and
| | - David Cassarino
- Pathologist, Los Angeles Medical Center (LAMC), Southern California Kaiser Permanente, Departments of Pathology and Dermatology, Los Angeles, CA
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3
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Kazemi S, Simmons E, Kiuru M, Tartar DM. Multifocal and recurrent cutaneous pseudolymphoma associated with lamotrigine and review of the literature. JAAD Case Rep 2022; 28:44-48. [PMID: 36097625 PMCID: PMC9463559 DOI: 10.1016/j.jdcr.2022.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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4
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Sernicola A, Dybala A, Gomes V, Maddalena P, Adotti F, Soda G, Muharremi R, Fino P, Del Duca E, Grieco T. Lymphomatoid drug reaction developed after BNT162b2 (Comirnaty) COVID-19 vaccine manifesting as pityriasis lichenoides et varioliformis acuta-like eruption. J Eur Acad Dermatol Venereol 2021; 36:e172-e174. [PMID: 34751995 DOI: 10.1111/jdv.17807] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/13/2021] [Accepted: 11/03/2021] [Indexed: 12/16/2022]
Affiliation(s)
- A Sernicola
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - A Dybala
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - V Gomes
- Pathological Anatomy Unit, Ospedale San Filippo Neri, Rome, Italy
| | - P Maddalena
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - F Adotti
- Department of Radiological Sciences, Oncology and Anatomical Pathology, "Sapienza" University of Rome, Rome, Italy
| | - G Soda
- Department of Radiological Sciences, Oncology and Anatomical Pathology, "Sapienza" University of Rome, Rome, Italy
| | - R Muharremi
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - P Fino
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - E Del Duca
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - T Grieco
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
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5
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Grieco T, Maddalena P, Sernicola A, Muharremi R, Basili S, Alvaro D, Cangemi R, Rossi A, Pellacani G. Cutaneous adverse reactions after COVID-19 vaccines in a cohort of 2740 Italian subjects: An observational study. Dermatol Ther 2021; 34:e15153. [PMID: 34622531 PMCID: PMC8646410 DOI: 10.1111/dth.15153] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/21/2021] [Accepted: 10/03/2021] [Indexed: 12/21/2022]
Abstract
An in‐depth characterization of the incidence, morphology, and onset of COVID‐19‐vaccines cutaneous adverse reactions is currently lacking. The existing literature on COVID‐19 vaccination‐related cutaneous adverse reactions largely focused on messenger RNA vaccines and mainly included type 1 hypersensitivity reactions, such as urticaria and angioedema. Other cutaneous manifestations are still poorly characterized and have been classified as delayed hypersensitivity rash. Our prospective observational study on a sample of 2740 subjects who underwent the COVID‐19 vaccination aimed at defining the prevalence of cutaneous adverse reactions and at identifying their timing of onset and their correlation with the administered dose. Vaccine‐related cutaneous adverse reactions occurred in 50 subjects. Patients were asked to complete a questionnaire on the type of COVID‐19 vaccine received, the time of onset of cutaneous reactions, and the dates of administration. Out of 2740 individuals who received the COVID‐19 vaccination, 50 were diagnosed with cutaneous adverse reactions to vaccine, after the first dose in 28 patients, after the second in 20, and after both in two. We reported localized injection site erythema in 12 patients and generalized cutaneous reactions in 38 patients. Our study shows that cutaneous adverse reactions to COVID‐19 vaccination are not common and most often occur after the first dose, recurring infrequently after the second dose. These reactions are usually easily manageable and, even in severe generalized cases, oral antihistamines and corticosteroids were sufficient for resolution. Therefore, except for immediate hypersensitivity reactions, cutaneous adverse reactions do not represent a contraindication to the completion of the vaccination cycle.
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Affiliation(s)
- Teresa Grieco
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Patrizia Maddalena
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Alvise Sernicola
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Rovena Muharremi
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Stefania Basili
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Domenico Alvaro
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Roberto Cangemi
- Department of Translational and Precision Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Alfredo Rossi
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Giovanni Pellacani
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
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6
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Schuler AM, Smith EH, Chaudet KM, Bresler SC, Gudjonsson JE, Kroshinsky D, Nazarian RM, Chan MP. Symmetric drug-related intertriginous and flexural exanthema: Clinicopathologic study of 19 cases and review of literature. J Cutan Pathol 2021; 48:1471-1479. [PMID: 34159622 DOI: 10.1111/cup.14090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/08/2021] [Accepted: 06/18/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Symmetric drug-related intertriginous and flexural exanthema (SDRIFE) is a cutaneous drug reaction characterized by gluteal/anogenital erythema and symmetric involvement of other intertriginous location(s) without systemic signs. Clinicopathologic characterization has been limited to case reports and small series. We describe 19 new cases and review the literature to better define the clinical and histopathologic spectrum of SDRIFE. METHODS Pathology archives were searched for "SDRIFE" and "baboon syndrome." Cases meeting clinical criteria were included. Clinical and histopathologic features were recorded. Previous reports of SDRIFE with histopathologic descriptions were reviewed. RESULTS Nineteen new cases were included, over half triggered by antibiotics. Six new causative medications were identified. Median onset was 7 days. Typical lesions were erythematous plaques or papules with or without scale. The most common histopathologic finding was superficial perivascular lymphocytic infiltrate followed by dermal eosinophils, spongiosis, and orthokeratosis. Basal vacuolization and apoptotic keratinocytes were less common. Interstitial histiocytes were present in almost half of our cases. Other findings included atypical lymphocytes and "flame figure." CONCLUSIONS Appreciation of the range of inciting medications and clinicopathologic features in SDRIFE will improve recognition of this condition. Although many histopathologic features overlap with other common dermatitides, biopsy may assist in excluding key clinical mimics.
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Affiliation(s)
- Andrew M Schuler
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily H Smith
- Department of Dermatology, University of Missouri, Columbia, Missouri, USA
| | - Kristine M Chaudet
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Scott C Bresler
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Johann E Gudjonsson
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Daniela Kroshinsky
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Rosalynn M Nazarian
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - May P Chan
- Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
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7
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Zhu Z, Yang J, Zhang C, Wang G, Fu M. Multiple disseminated purplish purpuric papules in an adolescent after administrating carbamazepine. Pediatr Dermatol 2020; 37:e40-e41. [PMID: 32706471 DOI: 10.1111/pde.14191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Zhenlai Zhu
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Jiankang Yang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Chen Zhang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Gang Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Meng Fu
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
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8
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Bush AE, Garcia A, Li J, Curry J, Chon SY. CD30 + lymphomatoid skin toxicity secondary to ipilimumab. JAAD Case Rep 2020; 6:251-253. [PMID: 32211493 PMCID: PMC7082605 DOI: 10.1016/j.jdcr.2016.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Amelia E Bush
- University of Texas Medical School at Houston, Houston, Texas
| | - Andres Garcia
- University of Texas Medical School at Houston, Houston, Texas
| | - Janet Li
- Department of Dermatology, University of Texas at Houston, Houston, Texas
| | - Jonathan Curry
- Department of Pathology and Dermatology, MD Anderson of Houston, Houston, Texas
| | - Susan Y Chon
- Department of Pathology and Dermatology, MD Anderson of Houston, Houston, Texas.,Department of Dermatology, Houston, Texas
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9
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Cheong KW, Lim GZ, Tan KB, Lim JHL. An instructive case of amlodipine-induced reversible granulomatous CD30 + T-cell pseudolymphoma. Australas J Dermatol 2020; 61:e346-e350. [PMID: 31965571 DOI: 10.1111/ajd.13240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 12/25/2019] [Indexed: 11/27/2022]
Abstract
We report an unusual case of drug-associated granulomatous CD30+ T-cell pseudolymphoma secondary to amlodipine. A 55-year-old Chinese man presented with a 6-month eruption of disseminated erythematous dermal papulonodules and annular infiltrated plaques over his neck and limbs symmetrically. Histopathology revealed a perivascular and interstitial infiltrate of histiocytes, eosinophils and morphologically normal lymphocytes associated with CD30 expression. The eruption improved rapidly after discontinuation of amlodipine and did not recur.
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Affiliation(s)
| | | | - Kong Bing Tan
- Department of Pathology, National University Health System and National University of Singapore, Singapore, Singapore
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10
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Mitteldorf C, Kempf W. Cutaneous pseudolymphoma—A review on the spectrum and a proposal for a new classification. J Cutan Pathol 2019; 47:76-97. [DOI: 10.1111/cup.13532] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 05/26/2019] [Accepted: 06/14/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Christina Mitteldorf
- Department of Dermatology, Venereology and AllergologyUniversity Medical Center Göttingen Germany
| | - Werner Kempf
- Kempf und Pfaltz, Histologische Diagnostik Zürich Switzerland
- Department of DermatologyUniversity Hospital Zurich Zurich Switzerland
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11
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Tatu AL, Elisei AM, Chioncel V, Miulescu M, Nwabudike LC. Immunologic adverse reactions of β-blockers and the skin. Exp Ther Med 2019; 18:955-959. [PMID: 31384329 PMCID: PMC6639944 DOI: 10.3892/etm.2019.7504] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 11/16/2018] [Indexed: 12/11/2022] Open
Abstract
β-Blockers are a widely utilised class of medication. They have been in use for a variety of systemic disorders including hypertension, heart failure and intention tremors. Their use in dermatology has garnered growing interest with the discovery of their therapeutic effects in the treatment of haemangiomas, their potential positive effects in wound healing, Kaposi sarcoma, melanoma and pyogenic granuloma, and, more recently, pemphigus. Since β-blockers are deployed in a variety of disorders, which have cutaneous co-morbidities such as psoriasis, their pertinence to dermatologists cannot be overstated. Likewise, β-blockers, like any other drug category, carry risks of side effects, some of which are dermatologic. These include triggering and exacerbation of psoriasis, psoriatic and rheumatoid arthritis, anaphylaxis, contact dermatitis, occupational contact dermatitis, Raynaud's disease, alopecia, lichen planus-like drug eruption, hyperhydrosis and vitiligo. While recent articles have focussed on the positive uses of β-blockers, it may also be wise to call our attention to the potential dermatologic adverse effects that may follow β-blocker use, as well as possible therapeutic approaches to these. This short review will focus on those dermatoses resulting from β-blocker use, which have an immunologic basis.
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Affiliation(s)
- Alin Laurentiu Tatu
- Medical and Pharmaceutical Research Unit/Competitive, Interdisciplinary Research Integrated Platform 'Dunărea de Jos', ReForm-UDJG; Research Centre in the Field of Medical and Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, Department of Pharmaceutical Sciences, 'Dunărea de Jos' University of Galați, 800010 Galati, Romania
| | - Alina Mihaela Elisei
- Medical and Pharmaceutical Research Unit/Competitive, Interdisciplinary Research Integrated Platform 'Dunărea de Jos', ReForm-UDJG; Research Centre in the Field of Medical and Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, Department of Pharmaceutical Sciences, 'Dunărea de Jos' University of Galați, 800010 Galati, Romania
| | - Valentin Chioncel
- Department of Cardio-Thoracic Pathology, Faculty of Medicine, 'Carol Davila' University of Medicine and Phamacy, 050474 Bucharest, Romania
| | - Magdalena Miulescu
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos University' of Galati, 800010 Galati, Romania
| | - Lawrence Chukwudi Nwabudike
- Department of Diabetic Foot Care, 'Prof. N. Paulescu' National Institute of Diabetes, 011233 Bucharest, Romania
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12
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Tian Z, Shiyu Z, Tao W, Li L, Yuehua L, Hongzhong J. Lymphoma or pseudolymphoma: A report of six cases and review of the literature. Dermatol Ther 2019; 32:e12807. [PMID: 30589489 DOI: 10.1111/dth.12807] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/11/2018] [Accepted: 12/25/2018] [Indexed: 02/07/2023]
Abstract
To explore and compare the clinical presentations and pathologic features of cutaneous pseudolymphomas (CPL) with primary cutaneous lymphomas. Review literature in order to improve the treatment of CPL. Six cases of CPLs were collected. The clinical, pathologic, and immunohistochemical features were performed and analyzed in Peking Union Medical College Hospital in 2018. Of six patients, the distributions and clinical manifestations of skin lesions are varied. The pathologic features consisted of atypical prominent lymphocytes infiltration. Of them, two cases imitated mycosis fungoides, one case mimicked primary cutaneous aggressive pidermotropic CD8+ cytotoxic T-cell lymphoma, one case was diagnosed as Jessner-Kanof lymphocyte infiltration and two cases primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder. With respect to etiology, one was result from insects bite and the others were on account of drugs. All cases were treated with systemic or local glucocorticoid. The skin lesions and systemic symptoms showed notable improvement after treatment. Follow-up visits were 2 years, half a year, and months, respectively, without relapse. These unique types of CPL were similar to cutaneous lymphomas in clinical manifestation and pathology. They were all sensitive to the treatment of externally or orally using glucocorticoid. The prognosis is generally good but needs long-term follow-up.
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Affiliation(s)
- Zhu Tian
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhang Shiyu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wang Tao
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Li
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liu Yuehua
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jin Hongzhong
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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13
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Wang ML, Chan MP. Comparative Analysis of Chilblain Lupus Erythematosus and Idiopathic Perniosis: Histopathologic Features and Immunohistochemistry for CD123 and CD30. Am J Dermatopathol 2018; 40:265-271. [DOI: 10.1097/dad.0000000000000945] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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CD30 Positive Lymphomatoid Angiocentric Drug Reactions: Characterization of a Series of 20 Cases. Am J Dermatopathol 2017; 39:508-517. [DOI: 10.1097/dad.0000000000000692] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Abstract
The term, cutaneous pseudolymphoma (PSL), refers to a group of lymphocyte-rich infiltrates, which either clinically and/or histologically simulate cutaneous lymphomas. Clinicopathologic correlation is essential to achieve the final diagnosis in cutaneous PSL and to differentiate it from cutaneous lymphomas. A wide range of causative agents (eg, Borrelia, injections, tattoo, and arthropod bite) has been described. Based on clinical and/or histologic presentation, 4 main groups of cutaneous PSL can be distinguished: (1) nodular PSL, (2) pseudo-mycosis fungoides, (3) other PSLs (representing distinct clinical entities), and (4) intravascular PSL. The article gives an overview of the clinical and histologic characteristics of cutaneous PSLs.
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Affiliation(s)
- Christina Mitteldorf
- Department of Dermatology, HELIOS Klinikum Hildesheim, Senator-Braun-Allee 33, Hildesheim 31134, Germany.
| | - Werner Kempf
- Kempf & Pfaltz, Histologische Diagnostik, Seminarstrasse 1, 8057 Zürich, Zurich, Switzerland; Department of Dermatology, University Hospital Zurich, Gloriastrassse 31, 8091 Zürich, Switzerland
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16
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Abstract
Cutaneous CD30+ T-cell lymphoproliferative disorders (CD30+ T-LPD) represent a spectrum encompassing lymphomatoid papulosis (LyP), primary cutaneous anaplastic large-cell lymphoma (pcALCL) and borderline lesions. They share the expression of CD30 as a common phenotypic marker. They differ however in their clinical presentation, the histological features and clinical course. Moreover, LyP and PcALCL show numerous clinical, histological and phenotypic variants. Overlapping features of LyP and pcALCL with themselves and with other cutaneous and systemic lymphomas emphasize the importance of careful clinicopathologic correlation and staging in the diagnosis of CD30+ T-LPD. Furthermore, an increasing number of inflammatory and infectious skin disorders harboring medium-sized to large CD30+ cells have to be considered in the differential diagnosis. Whereas the expression of CD30 in cutaneous CD30+ T-LPD stands for a favourable prognosis, its expression in other cutaneous and systemic lymphomas has a divergent impact. The assessment of CD30 expression does not only provide prognostic information, but is of potential therapeutic relevance as CD30 can serve as a therapeutic target. This review focuses on the clinicopathological and phenotypic spectrum of CD30+ T-LPD, its differential diagnoses and the role of CD30 as a diagnostic, prognostic and therapeutic marker.
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Affiliation(s)
- Werner Kempf
- Kempf und Pfaltz, Histologische Diagnostik, Zürich, Switzerland; Department of Dermatology, University Hospital Zurich, CH-8091, Zurich, Switzerland.
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17
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Abstract
We report a unique case of probable drug-induced CD30-positive lymphomatoid reaction. A 58-year-old woman presented with bilateral facial eruptions of 3 weeks duration composed of erythematosus papules in a linear distribution. The pathological features demonstrated a dense dermal and follicular infiltrate of many medium- to large-sized atypical CD30-positive lymphoid cells. The rash resolved rapidly after discontinuation of her medication 1 week later and did not recur. This case highlights the importance of clinicopathological correlation.
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19
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Gochoco A, Jones E, Soutendijk C, Alpdogan O, Shi W, Sahu J. Amlodipine-induced hypersensitivity reaction mimicking CD30(+) mycosis fungoides. JAAD Case Rep 2016; 2:320-2. [PMID: 27570814 PMCID: PMC4992011 DOI: 10.1016/j.jdcr.2016.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Ashley Gochoco
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Elizabeth Jones
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Christine Soutendijk
- Department of Internal Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Onder Alpdogan
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Wenyin Shi
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Joya Sahu
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
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20
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Romero-Pérez D, Blanes Martínez M, Encabo-Durán B. Cutaneous Pseudolymphomas. ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:640-51. [PMID: 27289134 DOI: 10.1016/j.ad.2016.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 04/16/2016] [Accepted: 05/01/2016] [Indexed: 11/19/2022] Open
Abstract
The term cutaneous pseudolymphoma refers to benign reactive lymphoid proliferations in the skin that simulate cutaneous lymphomas. It is a purely descriptive term that encompasses various reactive conditions with a varied etiology, pathogenesis, clinical presentation, histology, and behavior. We present a review of the different types of cutaneous pseudolymphoma. To reach a correct diagnosis, it is necessary to contrast clinical, histologic, immunophenotypic, and molecular findings. Even with these data, in some cases only the clinical course will confirm the diagnosis, making follow-up essential.
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Affiliation(s)
- D Romero-Pérez
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España
| | - M Blanes Martínez
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España.
| | - B Encabo-Durán
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España
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21
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De Souza A, Carter JB, Harris NL, Ferry JA, Duncan LM. Contribution of longitudinal follow up and clinical pathological correlation in the diagnosis CD30-positive skin infiltrates. J Cutan Pathol 2015; 42:452-8. [PMID: 25931140 DOI: 10.1111/cup.12510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 03/30/2015] [Accepted: 04/04/2015] [Indexed: 11/30/2022]
Abstract
The diagnosis of a CD30+ cutaneous infiltrate is often difficult and requires clinicopathologic correlation. To further evaluate this challenge, initial clinical and histopathologic diagnoses were correlated with final clinicopathologic diagnosis in 44 cases with CD30 immunopositivity. Dermatopathologic evaluation confirmed the initial clinical diagnosis in 65% of the suspected benign cases, all cases of suspected lymphomatoid papulosis (LyP), and 72% of clinically malignant cases. In the 25 patients with clinical suspicion for lymphoma, the histopathologic diagnoses included lymphoma in 18, LyP in 2, CD30+ lymphoproliferative disorder (CD30 LPD) in 3 and hypersensitivity reaction in 2 patients. Clinicopathologic correlation led to a change in three cases diagnosed histopathologically as anaplastic large cell lymphoma (ALCL) reclassified as LyP type C, and one patient diagnosed as CD30 LPD clinically evolved as herpes virus infection. Furthermore, five cases reported as CD30 LPD received more specific diagnoses after clinicopathologic correlation (LyP type C in three, and ALCL in two patients). Clinicopathologic correlation is essential in establishing the correct diagnosis of CD30 LPD, in particular the distinction of ALCL from LyP type C. In this setting, the histopathologic diagnosis of CD30 LPD is advisable in the absence of clinical data.
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Affiliation(s)
- Aieska De Souza
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Joi B Carter
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Nancy L Harris
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Judith A Ferry
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Lyn M Duncan
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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22
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Phase 1/2 study of mogamulizumab, a defucosylated anti-CCR4 antibody, in previously treated patients with cutaneous T-cell lymphoma. Blood 2015; 125:1883-9. [PMID: 25605368 DOI: 10.1182/blood-2014-09-600924] [Citation(s) in RCA: 169] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
This phase 1/2 study evaluated the efficacy of mogamulizumab, a defucosylated, humanized, anti-CC chemokine receptor 4 monoclonal antibody, in 41 pretreated patients with cutaneous T-cell lymphoma. No dose-limiting toxicity was observed and the maximum tolerated dose was not reached in phase 1 after IV infusion of mogamulizumab (0.1, 0.3, and 1.0 mg/kg) once weekly for 4 weeks followed by a 2-week observation. In phase 2, patients were dosed with 1.0 mg/kg mogamulizumab according to the same schedule for the first course followed by infusion every 2 weeks during subsequent courses until disease progression. The most frequent treatment-emergent adverse events were nausea (31.0%), chills (23.8%), headache (21.4%), and infusion-related reaction (21.4%); the majority of events were grade 1/2. There were no significant hematologic effects. Among 38 evaluable patients, the overall response rate was 36.8%: 47.1% in Sézary syndrome (n = 17) and 28.6% in mycosis fungoides (n = 21). Eighteen of 19 (94.7%) patients with ≥B1 blood involvement had a response in blood, including 11 complete responses. Given the safety and efficacy of mogamulizumab, phase 3 investigation of mogamulizumab is warranted in cutaneous T-cell lymphoma patients. This trial was registered at www.clinicaltrials.gov as #NCT00888927.
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23
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Abstract
Cutaneous CD30+ lymphoproliferative disorders are the second most common types of cutaneous T-cell lymphomas. They represent a well-defined spectrum encompassing lymphomatoid papulosis (LyP), primary cutaneous anaplastic large-cell lymphoma (pcALCL), and borderline lesions. They share the expression of CD30 as a common phenotypic hallmark, but they differ in their clinical presentation, course, and histologic features. New variants have been recently identified, including CD8+ epidermotropic LyP type D, angioinvasive LyP type E, and ALK-positive pcALCL. This review describes clinical, histopathologic, and phenotypic variants; their differential diagnoses (benign and malignant); and the role of CD30 as a diagnostic, prognostic, and therapeutic marker.
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Affiliation(s)
- Werner Kempf
- Kempf und Pfaltz, Histologische Diagnostik, Seminarstrasse 1, Zürich CH-8042, Switzerland; Department of Dermatology, University Hospital, Zürich CH-8091, Switzerland.
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24
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Gill K, Ariyan C, Wang X, Brady MS, Pulitzer M. CD30-positive lymphoproliferative disorders arising after regional therapy for recurrent melanoma: A report of two cases and analysis of CD30 expression. J Surg Oncol 2014; 110:258-64. [DOI: 10.1002/jso.23636] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 04/05/2014] [Indexed: 12/24/2022]
Affiliation(s)
- Kamraan Gill
- Department of Pathology; Memorial Sloan Kettering Cancer Center; New York New York
| | - Charlotte Ariyan
- Department of Surgery; Memorial Sloan Kettering Cancer Center; New York New York
| | - Xuan Wang
- Department of Surgery; Memorial Sloan Kettering Cancer Center; New York New York
| | - Mary Sue Brady
- Department of Surgery; Memorial Sloan Kettering Cancer Center; New York New York
| | - Melissa Pulitzer
- Department of Pathology; Memorial Sloan Kettering Cancer Center; New York New York
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