title: Acrodermatitis chronica atrophicans with pseudolymphomatous infiltrates.
abstract: In this study, we describe the clinicopathologic features of pseudolymphomatous infiltrates found within lesions of acrodermatitis chronica atrophicans (ACA). We studied 11 patients (10 females, 1 male, age range 60-88 years). The diagnosis of ACA in all cases was confirmed by clinicopathologic correlation and positive serology for Borrelia. Histopathologic examination revealed prominent, pseudolymphomatous inflammatory cell infiltrates in all cases, with 2 distinct patterns. Eight of 11 cases showed a band-like lymphocytic infiltrate, exocytosis of lymphocytes and a fibrotic papillary dermis, similar to features seen in mycosis fungoides. The other 3 cases showed dense, nodular-diffuse dermal infiltrates with many plasma cells and without germinal centers. The plasma cells expressed both kappa and lambda immunoglobulin light chains with a polyclonal pattern in all 3 cases. In conclusion, ACA may present with pseudolymphomatous infiltrates showing both a T-cell and, less frequently, a B-cell pattern. These lesions need to be distinguished from a cutaneous lymphoma. In the context of the knowledge of Borrelia-associated cutaneous lymphomas, follow-up seems advisable in these cases.
authors.affiliation: Research Unit of Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria.
authors.forename: Shang-Ian
authors.initials: SI
authors.lastname: Tee
authors.forename: Marcela
authors.initials: M
authors.lastname: Martínez-Escanamé
authors.forename: Daniel
authors.initials: D
authors.lastname: Zuriel
authors.forename: Isabella
authors.initials: I
authors.lastname: Fried
authors.forename: Ingrid
authors.initials: I
authors.lastname: Wolf
authors.forename: Cesare
authors.initials: C
authors.lastname: Massone
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cerroni
mesh_terms: D000169:Acrodermatitis / Q000235:genetics / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D001898:Borrelia / Q000235:genetics / Q000276:immunology; D001899:Borrelia Infections / Q000235:genetics / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D004269:DNA, Bacterial / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D015329:Gene Rearrangement, T-Lymphocyte; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000032:analysis; D007146:Immunoglobulin lambda-Chains / Q000032:analysis; D007150:Immunohistochemistry; D008214:Lymphocytes / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010950:Plasma Cells / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D011237:Predictive Value of Tests; D019310:Pseudolymphoma / Q000235:genetics / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D012867:Skin / Q000276:immunology / Q000382:microbiology / Q000473:pathology*
chemical_list: D015415:Biomarkers; D004269:DNA, Bacterial; D007145:Immunoglobulin kappa-Chains; D007146:Immunoglobulin lambda-Chains