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Anetoderma arising in cutaneous B-cell lymphoproliferative disease.
R C Kasper1, G S Wood, M Nihal
1Department of Pathology, University of California, San Francisco 94115, USA.
The American Journal of Dermatopathology
|April 4, 2001
Summary
Anetoderma, a skin condition causing elastic tissue loss, can be linked to cutaneous B-cell lymphomas. Biopsying anetoderma lesions is crucial for diagnosing these rare but serious lymphomas.
Area of Science:
- Dermatology
- Oncology
- Pathology
Background:
- Anetoderma is characterized by localized skin atrophy due to elastic tissue deficiency.
- It can arise secondary to inflammatory conditions or around neoplasms.
- Previous reports suggest anetoderma may occur in cutaneous lymphoma lesions.
Observation:
- Two patients presented with anetoderma and were diagnosed with low-grade cutaneous B-cell lymphomas.
- One patient had an urticarial reaction with plasma cells; biopsy revealed lymphoid follicles and plasmacytoid lymphocytes with lambda light chain predominance.
- The other patient was a renal transplant recipient diagnosed with post-transplant lymphoproliferative disorder.
Findings:
- Both patients demonstrated an intimate association between anetoderma and cutaneous B-cell lymphoproliferative disorders.
- The neoplastic cells or associated inflammatory cells may cause anetoderma.
- One case presented with interstitial neutrophils and few lymphocytes, highlighting a potential diagnostic pitfall for B-cell lymphoma.
Implications:
- Biopsy of anetoderma lesions is recommended to rule out lymphomatous infiltrates.
- Clonality studies are advised even with sparse plasma cells.
- Cutaneous B-cell lymphoma is now associated with elastolysis, alongside conditions like granulomatous slack skin and cutis laxa.