title: Cutaneous B-cell neoplasms mimicking granulomatous rosacea or rhinophyma.
abstract: BACKGROUND
  Unlike T-cell neoplasms, B-cell lymphoproliferative disorders have a limited clinical spectrum of skin involvement. Cutaneous B-cell neoplasms mimicking rosacea or rhinophyma are rare.
  
  
  METHODS
  We described 12 patients with B-cell lymphoproliferative neoplasms presenting with a facial eruption clinically mimicking rosacea or rhinophyma. Eleven patients were women; ages ranged from 36 to 81 years. The clinical presentation included small papules on the nose and cheeks and around the eyes mimicking granulomatous rosacea; nodules on the nose, cheeks, chin, or forehead mimicking phymatous rosacea; or a combination of both. Three patients had preexisting erythematotelangiectatic rosacea and 1 had rhinophyma. Based on a clinicopathologic correlation and B-cell clonality analysis, the diagnosis was primary cutaneous follicular center B-cell lymphoma in 4 cases, primary cutaneous marginal zone lymphoma in 6, and skin involvement of chronic lymphocytic leukemia in 2. All patients had an indolent course as expected for their disease.
  
  
  CONCLUSIONS
  Cutaneous involvement of B-cell neoplasms may mimic granulomatous rosacea or rhinophyma. This unusual clinical presentation is more common in women and appears in the setting of preexisting rosacea or as a new eruption. Proliferative B-cell disorders should be added to the differential diagnosis of symmetric papular or papulonodular eruptions of the face.
authors.affiliation: Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Israel. avivb@post.tau.ac.il
authors.forename: Aviv
authors.initials: A
authors.lastname: Barzilai
authors.forename: Hana
authors.initials: H
authors.lastname: Feuerman
authors.forename: Pietro
authors.initials: P
authors.lastname: Quaglino
authors.forename: Michael
authors.initials: M
authors.lastname: David
authors.forename: Meora
authors.initials: M
authors.lastname: Feinmesser
authors.forename: Marisa
authors.initials: M
authors.lastname: Halpern
authors.forename: Edit
authors.initials: E
authors.lastname: Feldberg
authors.forename: Carlo
authors.initials: C
authors.lastname: Tomasini
authors.forename: Hilla
authors.initials: H
authors.lastname: Tabibian-Keissar
authors.forename: Ninette
authors.initials: N
authors.lastname: Amarilgio
authors.forename: Emmilia
authors.initials: E
authors.lastname: Hodak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005145:Face; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000473:pathology; D016393:Lymphoma, B-Cell / Q000175:diagnosis* / Q000473:pathology; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012224:Rhinophyma / Q000175:diagnosis / Q000473:pathology; D012393:Rosacea / Q000175:diagnosis / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology