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Bhabha FK, McCormack C, Campbell BA, Lade S, Buelens O, Van Der Weyden C, Prince HM. CD30-positive lymphoproliferative disorders-An Australian Clinical Practice Statement from the Peter MacCallum Cancer Centre. Australas J Dermatol 2023; 64:194-203. [PMID: 36892928 DOI: 10.1111/ajd.14016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 02/01/2023] [Accepted: 02/12/2023] [Indexed: 03/10/2023]
Abstract
The CD30-postive lymphoproliferative disorders, including lymphomatoid papulosis and primary cutaneous anaplastic large cell lymphoma, account for up to 30% of all cutaneous T-cell lymphomas (CTCLs) and are the second most common form of CTCLs after mycosis fungoides. Both conditions differ in their clinical presentations; however, they share the expression of the CD30 antigen as a common immunophenotypic hallmark. There is a wide spectrum of management options depending on factors such as extent of disease, staging and treatment tolerability. This Clinical Practice Statement is reflective of the current clinical practice in Australia.
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Affiliation(s)
- Friyana K Bhabha
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Christopher McCormack
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Belinda A Campbell
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Clinical Pathology, The University of Melbourne, Parkville, Victoria, Australia
| | - Stephen Lade
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Odette Buelens
- Nurse Practitioner, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Carrie Van Der Weyden
- Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - H Miles Prince
- Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Machan S, Juárez Martín Á, Cullen Aravena D, Haro R, Pielasinski Ú, Fuertes L, Córdoba R, Santonja C, Rodríguez-Pinilla SM, Requena L. Acral lymphomatoid papulosis: Report of five cases, differential diagnosis, and review. J Cutan Pathol 2021; 48:650-658. [PMID: 33269496 DOI: 10.1111/cup.13929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/17/2020] [Accepted: 11/21/2020] [Indexed: 11/26/2022]
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.
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Affiliation(s)
- Salma Machan
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - África Juárez Martín
- Department of Dermatology, Complejo Asistencial Universitario de Palencia, Palencia, Spain
| | | | - Rosario Haro
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Úrsula Pielasinski
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Laura Fuertes
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Raúl Córdoba
- Department of Hematology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Carlos Santonja
- Department of Pathology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | | | - Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
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3
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Martinez-Cabriales SA, Walsh S, Sade S, Shear NH. Lymphomatoid papulosis: an update and review. J Eur Acad Dermatol Venereol 2019; 34:59-73. [PMID: 31494989 DOI: 10.1111/jdv.15931] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 08/08/2019] [Indexed: 12/13/2022]
Abstract
Lymphomatoid papulosis (LyP) is a benign chronic often relapsing skin condition that belongs to the CD30-positive cutaneous lymphoproliferative disorders. LyP typically presents as crops of lesions with a tendency to self-resolve, and morphology can range from solitary to agminated or diffuse papules and plaques to nodules or tumours. The clinical-histological spectrum can range from borderline cases to overlap with primary cutaneous anaplastic cell lymphoma (pcALCL). Histology and immunophenotype commonly show overlap with other CD30-positive disorders and sometimes may be identical to pcALCL, making its diagnosis more difficult. Patients with LyP have an increased risk of developing a second neoplasm such as mycosis fungoides, pcALCL and/or Hodgkin lymphoma. Clinical correlation allows its proper classification and diagnosis, which is fundamental for treatment and prognosis. This review focuses on the clinical appearance, histopathological features, diagnosis, differential diagnosis and management of LyP.
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Affiliation(s)
- S A Martinez-Cabriales
- Department of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Dermatology, Autonomous University of Nuevo Leon, San Nicolas de los Garza, Mexico
| | - S Walsh
- Department of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - S Sade
- Department of Pathology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - N H Shear
- Department of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Dermatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Wehkamp U, Weichenthal M, Klapper W, Schwarz T, Oschlies I. Unilesional locally recurrent lymphomatoid papulosis with variable histological presentation. Leuk Lymphoma 2017; 59:262-264. [PMID: 28562138 DOI: 10.1080/10428194.2017.1323274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ulrike Wehkamp
- a Department of Dermatology , University Hospital Schleswig-Holstein , Campus Kiel , Germany
| | - Michael Weichenthal
- a Department of Dermatology , University Hospital Schleswig-Holstein , Campus Kiel , Germany
| | - Wolfram Klapper
- b Department of Pathology , Hematopathology Section, University Hospital Schleswig-Holstein , Campus Kiel , Germany
| | - Thomas Schwarz
- a Department of Dermatology , University Hospital Schleswig-Holstein , Campus Kiel , Germany
| | - Ilske Oschlies
- b Department of Pathology , Hematopathology Section, University Hospital Schleswig-Holstein , Campus Kiel , Germany
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Buder K, Wendel A, Cerroni L, Goebeler M, Kerstan A. A Case of Lymphomatoid Papulosis Limited to Becker's Melanosis. Dermatology 2013; 226:124-7. [DOI: 10.1159/000346752] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 12/24/2012] [Indexed: 11/19/2022] Open
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6
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Eminger LA, Shinohara MM, Kim EJ, Heymann WR. Clinicopathologic challenge: acral lymphomatoid papulosis. Int J Dermatol 2012; 51:531-4. [DOI: 10.1111/j.1365-4632.2011.05303.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pileri A, Bacci F, Neri I, Ciabatti S, Stefoni V, Zinzani P, Patrizi A. Persistent Agmination of Lymphomatoid Papulosis: An Ongoing Debate. Dermatology 2012; 225:131-4. [DOI: 10.1159/000342201] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 07/27/2012] [Indexed: 11/19/2022] Open
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Lymphomatoid Papulosis Followed by Pityriasis Lichenoides: A Common Pathogenesis? Am J Dermatopathol 2011; 33:835-40. [DOI: 10.1097/dad.0b013e3181f4d8c3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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EORTC, ISCL, and USCLC consensus recommendations for the treatment of primary cutaneous CD30-positive lymphoproliferative disorders: lymphomatoid papulosis and primary cutaneous anaplastic large-cell lymphoma. Blood 2011; 118:4024-35. [PMID: 21841159 DOI: 10.1182/blood-2011-05-351346] [Citation(s) in RCA: 260] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Primary cutaneous CD30(+) lymphoproliferative disorders (CD30(+) LPDs) are the second most common form of cutaneous T-cell lymphomas and include lymphomatoid papulosis and primary cutaneous anaplastic large-cell lymphoma. Despite the anaplastic cytomorphology of tumor cells that suggest an aggressive course, CD30(+) LPDs are characterized by an excellent prognosis. Although a broad spectrum of therapeutic strategies has been reported, these have been limited mostly to small retrospective cohort series or case reports, and only very few prospective controlled or multicenter studies have been performed, which results in a low level of evidence for most therapies. The response rates to treatment, recurrence rates, and outcome have not been analyzed in a systematic review. Moreover, international guidelines for staging and treatment of CD30(+) LPDs have not yet been presented. Based on a literature analysis and discussions, recommendations were elaborated by a multidisciplinary expert panel of the Cutaneous Lymphoma Task Force of the European Organization for Research and Treatment of Cancer, the International Society for Cutaneous Lymphomas, and the United States Cutaneous Lymphoma Consortium. The recommendations represent the state-of-the-art management of CD30(+) LPDs and include definitions for clinical endpoints as well as response criteria for future clinical trials in CD30(+) LPDs.
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Busick TL, Bennett DD, Cohen JB. Pyoderma gangrenosum responding to ciclosporin without adverse effects in a patient with lymphomatoid papulosis. Clin Exp Dermatol 2010; 35:918-9. [DOI: 10.1111/j.1365-2230.2010.03835.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Acral lymphomatoid papulosis. J Am Acad Dermatol 2010; 62:530-1. [DOI: 10.1016/j.jaad.2009.02.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2008] [Revised: 02/15/2009] [Accepted: 02/17/2009] [Indexed: 11/19/2022]
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Localized lymphomatoid papulosis. J Am Acad Dermatol 2010; 62:353-6. [DOI: 10.1016/j.jaad.2009.01.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2008] [Revised: 01/28/2009] [Accepted: 01/28/2009] [Indexed: 11/22/2022]
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Allabert C, Estève E, Joly P, Troussard X, Comoz F, Courville P, Morice A, Verneuil L, Leroy D, Dompmartin A. Atteinte muqueuse dans la papulose lymphomatoïde : quatre cas. Ann Dermatol Venereol 2008; 135:273-8. [DOI: 10.1016/j.annder.2007.11.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2007] [Accepted: 11/23/2007] [Indexed: 11/26/2022]
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Korpusik D, Ruzicka T. [Clinical course and therapy of lymphomatoid papulosis. Experience with 17 cases and literature review]. Hautarzt 2008; 58:870-81. [PMID: 17486304 DOI: 10.1007/s00105-007-1295-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Lymphomatoid papulosis is a rare disease with a worldwide incidence of 1.2 to 1.9 per 1 million. It affects all age groups with a peak incidence between 30 and 40 years and an apparent male predominance. Occurrence in childhood has also been described. Both the etiology and pathogenesis of the disease are unknown. The clinical presentation is extremely variable and frequently uncharacteristic. A papulonodular eruption, characterized by self-healing skin lesions appearing in crops can often be seen, particularly on extremities. We report on 17 patients, including 2 children. By detailing 6 cases we point out the variable morphologic manifestations, the different courses of disease and therapeutic options.
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MESH Headings
- Aged
- Biopsy
- Cell Transformation, Neoplastic/pathology
- Child
- Child, Preschool
- Diagnosis, Differential
- Eosinophils/pathology
- Female
- Follow-Up Studies
- Histiocytes/pathology
- Humans
- Ki-1 Antigen/analysis
- Lymphocytes/pathology
- Lymphoma, Large-Cell, Anaplastic/classification
- Lymphoma, Large-Cell, Anaplastic/diagnosis
- Lymphoma, Large-Cell, Anaplastic/pathology
- Lymphoma, Large-Cell, Anaplastic/therapy
- Lymphomatoid Papulosis/classification
- Lymphomatoid Papulosis/diagnosis
- Lymphomatoid Papulosis/pathology
- Lymphomatoid Papulosis/therapy
- Male
- Middle Aged
- Mitosis/physiology
- Neutrophils/pathology
- Skin/pathology
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Affiliation(s)
- D Korpusik
- Hautklinik des Universitätsklinikums Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
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Affiliation(s)
- Vishakha Sharma
- Section of Dermatology, Department of Medicine, University of Chicago, Chicago, IL, USA.
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Hernández-Martín A, Torrelo A, Vélez D, Colmenero I, Zambrano A. [Localized pityriasis lichenoides]. ACTAS DERMO-SIFILIOGRAFICAS 2007; 98:47-9. [PMID: 17374334 DOI: 10.1016/s0001-7310(07)70009-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Pitiryasis lichenoides is a papulosquamous disorder of unknown etiology frequently seen in the pediatric population. The lesions are usually widespread on the trunk and extremities, and only exceptional cases of localized forms have been reported. We report a 9-year-old patient with recurrent crops of pitiryasis lichenoides lesions exclusively involving the lower abdomen.
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Hernández-Martín A, Torrelo A, Vélez D, Colmenero I, Zambrano A. Localized Pitiryasis Lichenoides. ACTAS DERMO-SIFILIOGRAFICAS 2007. [DOI: 10.1016/s1578-2190(07)70390-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Pujol RM, Muret MPG, Bergua P, Bordes R, Alomar A. Oral Involvement in Lymphomatoid Papulosis. Dermatology 2005; 210:53-7. [PMID: 15604547 DOI: 10.1159/000081485] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2003] [Accepted: 05/28/2004] [Indexed: 11/19/2022] Open
Abstract
Oral involvement in cutaneous CD30+ T-cell lymphoid proliferations is rare and has received little attention in the dermatologic literature. The authors report 2 patients with self-healing, recurrent papulonodular eruptions with the classic clinical, histopathological and immunophenotypic features of lymphomatoid papulosis, which developed two ulcerated papules and an ulcerative nodule on the dorsum of the tongue, respectively. The lesions appeared coincident with a new cutaneous relapse of the disease. Histopathological and immunophenotypic features were similar to those of the cutaneous lesions. All lesions regressed spontaneously after several weeks. Since then, and after follow-up periods of 3 and 7 years, respectively, no evidence of extracutaneous involvement has been detected. Oral involvement in lymphomatoid papulosis is an uncommon event, probably without prognostic significance. Previously reported cases are reviewed. The differential diagnosis of atypical T-cell lymphoid infiltrates observed in the oral mucosa is discussed.
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Affiliation(s)
- Ramon M Pujol
- Department of Dermatology, Hospital del Mar, IMAS, Barcelona, Spain.
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Abstract
This paper identifies legal issues of relevance to the diagnosis and treatment of cluster headache, including areas of actual and potential malpractice liability. Legal topics that are relevant to cluster headache can be divided into five categories: diagnostic-related issues, risks inherent in the disease process, prescribing and treatment-related problems, research-related issues, and disability determination.
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Affiliation(s)
- Elizabeth Loder
- 2 Ropes & Gray LLP, One International Place, Boston, MA 02115, USA.
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