Treatment of facial reactive B-cell rich lymphoid proliferation with dapsone

Reactive B-cell rich lymphoid proliferation (rB-LP), once called pseudolymphoma, is a benign lymphoproliferative disorder, which is histologically characterized by dense dermal infiltrate forming reactive germinal centers with tingible body macrophages. The disease frequently involves the face, scalp, and ear lobes. Treatment includes topical or intralesional steroids, surgical resection, ultraviolet therapy, laser treatment, and radiation therapy. Cases with multiple skin lesions, however, are difficult to treat with local therapies. Oral steroids are sometimes used, although the variety of side effects and recurrence during decreases in the dosage are the main problem. Here we report seven cases of rB-LP treated with dapsone, which has anti-inflammatory effect. Although the number of cases was limited, there was a trend that patients with multiple nodules on both sides of the face showed a good response. The limitations of this study include it being a case series from a single institute, and possible effects of topical steroids. We can, however, safely say that dapsone may be useful in some patients with rB-LP.