Diagnostic and Therapeutic Challenges of Cutaneous Lymphoid Hyperplasia in the Facial Region: A Case Report

Cutaneous lymphoid hyperplasia (CLH) is a benign skin disorder that clinically and histopathologically mimics cutaneous lymphoma, making it a diagnostic challenge. CLH can exhibit a predominance of B cells, T cells, or a combination of both. This report illustrates a case of a 27-year-old male patient with an erythematous plaque on his cheek, initially histopathologically described as lymphoid hyperplasia of B-immunophenotype. The lesion recurred years later, necessitating a thorough diagnostic investigation. Clonality analysis coupled with imaging led to the exclusion of cutaneous lymphoma, therefore confirming B-cell CLH as the final diagnosis. Treatment options were limited by the esthetic demands of the facial region, as well as the patient's age, considering the risks of radiotherapy in younger patients. Furthermore, the possibility of progression to cutaneous lymphoma was considered, highlighting the importance of long-term patient follow-up.