Lymphocytoma cutis

Lymphocytoma cutis is a rare, chronic, benign cutaneous B-cell lymphoproliferative condition usually presenting with red-purple papules, nodules or plaques predominantly on the head and neck.

This chapter is set out as follows:

• The cause is unknown

• It most commonly affects adults under the age of 40, with females affected more than males

Distribution

• ​Lesions are usually multiple but can be single 
• Mainly the head and neck, especially the ear lobes. Rarely, lesions can affect other sites
• Disseminated lymphocytoma cutis is rarer, can involve any site, and mainly affects elderly patients

Morphology

• Red-purple, smooth papules, nodules or plaques
• Lesions enlarge slowly up to 3-5 cm

• Histology is characterised by foci of lymphocytes in the dermis, permeated by histiocytes, bringing about a follicular arrangement. The majority of lymphocytes are B cells, germinal centres are frequent, and a cuff of reactive T cells may be seen around the periphery. Histological distinction from primary cutaneous B-cell marginal zone lymphoma can be difficult

• No treatment is known to be effective

• In disseminated cases there have been reports of some lesions improving with potent or super-potent topical steroids, intralesional steroids and hydroxychloroquine

• Lymphocytoma cutis generally runs a benign, protracted course. Patients require long-term follow-up as there are reports of a number of cases progressing to primary cutaneous B-cell lymphoma