Anetodermic primary cutaneous B-cell lymphoma: a unique clinicopathological presentation of lymphoma possibly associated with antiphospholipid antibodies.
BACKGROUND
Primary cutaneous B-cell lymphoma manifested by anetoderma has been reported in 7 cases. In all, the secondary anetoderma developed in lesions of marginal-zone lymphoma or posttransplant lymphoproliferative disorder resembling marginal-zone lymphoma. The mechanisms underlying the destruction of elastic tissue in anetoderma are unclear. However, there is growing evidence linking primary anetoderma with a wide range of immunologic abnormalities, the most common being the presence of antiphospholipid antibodies.


METHODS
We analyzed data from 5 patients (3 male, 2 female) with clinical and histopathological features of anetodermic primary cutaneous B-cell lymphoma. Three had marginal-zone lymphoma and 2 had follicle-center cell lymphoma. In all, secondary anetoderma developed in self-regressing nodules/plaques of the lymphoma. Two patients also had lesions clinically and histopathologically compatible with primary anetoderma. Associated immunologic diseases were systemic lupus erythematosus-like disease and rheumatoid arthritis (1 patient each; not in patients with primary anetoderma). Antiphospholipid antibodies were found in 4 patients.


CONCLUSIONS
Anetodermic primary cutaneous B-cell lymphoma is a rare and unique clinicopathological manifestation not only of marginal-zone lymphoma, as previously described, but also of follicle-center cell lymphoma. This type of secondary anetoderma, like primary anetoderma, might be associated with immunologic disorders, particularly antiphospholipid antibodies.
Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel 49100. hodake@post.tau.ac.il
Emmilia
E
Hodak
Hana
H
Feuerman
Aviv
A
Barzilai
Michael
M
David
Lorenzo
L
Cerroni
Meora
M
Feinmesser
D000328:Adult; D000368:Aged; D057088:Anetoderma / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D017152:Antibodies, Antiphospholipid / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000209:etiology* / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000209:etiology / Q000473:pathology* / Q000628:therapy
D017152:Antibodies, Antiphospholipid