Lymphomatoid Papulosis Type E With T-Cell Receptor Gamma Positivity.

Area of Science:

• Dermatology
• Hematology
• Oncology

Background:

• Lymphomatoid papulosis (LyP) is a lymphoproliferative disorder with a chronic, relapsing course.
• Diagnosis relies on clinical and histopathological findings, with six recognized subtypes.
• LyP type E typically presents as large necrotic nodules/ulcers, characterized by angioinvasion/angiodestruction of CD8/CD30+ T cells.

Observation:

• This report describes an atypical case of LyP type E.
• The patient presented with widespread small papulonecrotic eruptions, deviating from the typical presentation.
• Immunohistochemistry revealed CD8, CD30, CD56, and TCR-γ positive atypical lymphocytes with angioinvasion.

Findings:

• The case highlights an unusual clinical manifestation of LyP type E.
• Atypical immunohistochemical profile with CD56 and TCR-γ positivity was observed.
• Successful treatment was achieved using low-dose methotrexate.

Implications:

• This case expands the understanding of LyP type E's clinical spectrum.
• It underscores the importance of considering atypical presentations in diagnosing LyP.
• Low-dose methotrexate may be an effective treatment option for such cases.