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Acrodermatitis chronica atrophicans with pseudolymphomatous infiltrates
Shang-Ian Tee1, Marcela Martínez-Escanamé, Daniel Zuriel
1Research Unit of Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria.
The American Journal of Dermatopathology
|November 14, 2012
Summary
Acrodermatitis chronica atrophicans (ACA) can present with pseudolymphomatous infiltrates, mimicking cutaneous lymphoma. Distinguishing these Borrelia-associated lesions is crucial for proper patient management and follow-up.
Area of Science:
- Dermatopathology
- Infectious Diseases
- Oncology
Background:
- Acrodermatitis chronica atrophicans (ACA) is a late manifestation of Borrelia infection.
- Pseudolymphomatous infiltrates can occur in various inflammatory conditions.
- Distinguishing these infiltrates from cutaneous lymphoma is clinically important.
Purpose of the Study:
- To describe the clinicopathologic features of pseudolymphomatous infiltrates in ACA lesions.
- To identify distinct histopathologic patterns of these infiltrates.
- To emphasize the need for differentiation from cutaneous lymphoma.
Main Methods:
- Clinicopathologic correlation in 11 ACA patients.
- Histopathologic examination of skin lesions.
- Immunohistochemical analysis of plasma cell infiltrates.
Main Results:
- All 11 cases showed prominent pseudolymphomatous inflammatory infiltrates.
- Two patterns observed: band-like lymphocytic infiltrate (8/11) and dense nodular-diffuse infiltrate with plasma cells (3/11).
- Plasma cells in the latter group showed polyclonal kappa and lambda light chain expression.
Conclusions:
- ACA can present with pseudolymphomatous infiltrates, exhibiting T-cell or B-cell patterns.
- These findings necessitate differentiation from cutaneous lymphoma.
- Follow-up is recommended due to the association with Borrelia and potential for lymphoma.
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