A case of recurrent pseudolymphomatous folliculitis: A mimic of cutaneous lymphoma.
Pseudolymphomatous folliculitis is a rare entity. We present a 62-year-old man with a recurrent solitary nodule on his nose requiring multiple excisions. Microscopic examination of the excisions showed a dense lymphocytic infiltrate containing numerous histiocytes and S100+, CD1a+ dendritic cells that surrounded and infiltrated hypertrophic hair follicles. Diffuse sheets of CD3+ T cells and nodular clusters of CD20+ B cells were also seen. There was normal reactive pattern of follicular centers. Light chain restriction was not detected. T-cell receptor and immunoglobulin heavy chain gene rearrangements by polymerase chain reaction revealed negative findings. A diagnosis of pseudolymphomatous folliculitis was made based on the hypertrophic hair follicles, periadnexal S100+ and CD1a+ dendritic cells, and negative clonal gene rearrangement study findings. This case of recurrent pseudolymphomatous folliculitis is instructive because of the resemblance to cutaneous lymphomas and cutaneous lymphoid hyperplasias, and the need for correct diagnosis to avoid overtreatment of this indolent condition.
Kwon
Eun Ji
EJ
Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA.
Kristjansson
Arni K
AK
Meyerson
Howard J
HJ
Fedele
Gregory M
GM
Tung
Rebecca C
RC
Sellheyer
Klaus
K
Tuthill
Ralph J
RJ
Honda
Kord S
KS
Gilliam
Anita C
AC
McNiff
Jennifer M
JM
D001402:B-Lymphocytes / Q000473:pathology; D017252:CD3 Complex / Q000032:analysis; D003937:Diagnosis, Differential; D005499:Folliculitis / Q000473:pathology*; D015321:Gene Rearrangement; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis; D009669:Nose Neoplasms / Q000473:pathology; D016133:Polymerase Chain Reaction; D012878:Skin Neoplasms / Q000473:pathology*; D013601:T-Lymphocytes / Q000473:pathology
D017252:CD3 Complex; D009363:Neoplasm Proteins; C081763:sarcoma-associated antigen S1