Cutaneous Lymphoid Hyperplasia: A Case Report

Cutaneous lymphoid hyperplasia (CLH) is a localized reactive proliferation of polyclonal lymphoid cells in the skin. The condition can be idiopathic or result from various stimuli, with indolent nodular/papular lesions on exposed body areas. Despite its benign nature, it mimics cutaneous lymphomas both clinically and histologically. We present the case of a 56-year-old male patient who developed multiple erythematous papules and nodules on the forehead, gradually increased in size and number over a period of two months. Routine histological studies revealed dermal lymphocytic infiltrates, multiple lymphoid follicles with germinal centers containing tingible body macrophages. Immunohistochemical staining revealed a mixed population of B and T lymphocytes. The reactive germinal centers retained immunoreactivity for CD10 but did not show co-expression of BCL2. These findings confirmed the diagnosis of CHL. The patient was treated with three sessions of pulsed dye laser (PDL), followed by intralesional steroid and topical tacrolimus, with uneventful recovery after five years of follow-up. We also discuss the etiology, clinical features, diagnosis, and available management modalities for CLH.