Indolent CD8‐positive lymphoid proliferation of acral sites: three further cases of a rare entity and an update on a unique patient

Abstract

Indolent CD8-positive lymphoid proliferation of acral sites is a distinctive and readily identifiable entity and should be included in the next consensus revision of cutaneous lymphoma classification. Although cases described thus far have followed an indolent clinical course, dermatologists should remain guarded about the prognosis and full staging and longitudinal observation are recommended until this condition is better understood.

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“…2 We report the first case of treatment by Mohs micrographic surgery. Treatment options have included careful clinical surveillance, corticosteroids, radiotherapy, and surgical excision.…”

“…2 Despite this increase in the number of reported cases, the diagnosis is not yet recognized in the (2005) WHO/EORTC classification. A recent review article identified a total of 23 case reports or series, totaling 51 patients with CD8-positive lymphoid proliferations of acral sites.…”

“…2 Despite this increase in the number of reported cases, the diagnosis is not yet recognized in the (2005) WHO/EORTC classification. 2 Clinically, the differential diagnosis includes primary cutaneous lymphoma (particularly B-cell), arthropod reaction, angiolymphoid hyperplasia with eosinophils, granuloma faciale, and other granulomatous processes. While lesions are typically solitary, bilateral and multifocal disease has been reported.…”

“…2 In addition, epidermotropism is usually lacking, with only two of the 51 cases reported demonstrating epidermotropism. By definition, histopathologic examination will reveal strong CD8 positivity.…”

“…2 Given its predominance in the dermatopathology literature, the diagnosis of indolent CD8-positive lymphoid proliferation is much better recognized by dermatopathologists. Of the 23 reported articles, the majority are published in dermatopathology literature, with only nine reported in clinical dermatology.…”