Lobular Panniculitis due to Borrelia burgdorferi Infection Mimicking Subcutaneous Panniculitis-Like T-Cell Lymphoma

Kempf, Werner; Kazakov, Dmitry V.; Kutzner, Heinz

doi:10.1097/dad.0b013e31827132cb

Cited by 19 publications

(16 citation statements)

References 22 publications

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“…In our case, the histopathology appears most consistent with a distinct and rare, but increasingly cited, cutaneous sign of Lyme disease, Borrelia‐associated panniculitis . The few reported cases appear in Table . Our case differs from these reports in that the dermis is not spared.…”

Section: Discussioncontrasting

confidence: 56%

Septolobular panniculitis in disseminated Lyme borreliosis

et al. 2018

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Lyme disease classically evolves through clinical manifestations according to the stage of illness. Because many of the systemic symptoms are non-specific, and because serology may yield false negative results, cutaneous findings merit even greater importance to diagnosis. The prototypical skin lesion, erythema migrans (EM), occurs early and is the only independent diagnostic clinical feature according to the guidelines of the Infectious Diseases Society of America. EM itself has protean guises, being, at times, vesicular, indurated, necrotic, purpuric, solid, or targetoid, but it is not the sole Borrelia-associated skin lesion. Acrodermatitis chronica atrophicans and borrelial lymphocytoma cutis are other well-known skin manifestations. A rare cutaneous manifestation that is increasingly reported in Lyme patients is panniculitis, which develops after dissemination of the spirochete. We present such a case in a patient who was initially treated for cellulitis as well as neck and radicular leg pain, thereby expanding the cutaneous spectrum of Lyme disease.

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Section: Discussioncontrasting

confidence: 56%

Septolobular panniculitis in disseminated Lyme borreliosis

et al. 2018

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“…The diagnosis was established according to the World Health Organization criteria, and we believe that in all our cases any reactive type of panniculitis (e.g. in lupus erythematosus, borreliosis and cytophagic histiocytic panniculitis) could be excluded by combined histomorphological, clinical and molecular criteria. The typical immunophenotype with expression of TCR‐α/β was demonstrated in all but one case (case 2, Table ), who displayed partial expression of TCR‐α/β and TCR‐γ/δ.…”

Section: Clinical Features Of the 11 Paediatric Cases Of Subcutaneousmentioning

confidence: 98%

Subcutaneous panniculitis-like T-cell lymphoma in children: a detailed clinicopathological description of 11 multifocal cases with a high frequency of haemophagocytic syndrome

et al. 2015

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“…In addition, we recently described a case of B. burgdorferiassociated lobular panniculitis resembling subcutaneous panniculitis-like T-cell lymphoma typified by a T-cell infiltrate with cytotoxic phenotype. 27 These observations and the presented case demonstrate that cutaneous Borrelia infection is occasionally associated with T-cell-rich infiltrates mimicking various forms of cutaneous T-cell lymphomas or secondary cutaneous infiltrates of T-cell neoplasms, such as prolymphocytic T-cell leukemia/lymphoma.…”

Section: Discussionmentioning

confidence: 85%

Cutaneous Borreliosis With a T-Cell–Rich Infiltrate and Simultaneous Involvement by B-Cell Chronic Lymphocytic Leukemia With t(14;18)(q32;q21)

Kempf¹,

Kazakov

Hübscher

et al. 2015

The American Journal of Dermatopathology

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: Pseudolymphomatous infiltrates in Borrelia infection of the skin most commonly manifest with dense B-cell infiltrates and plasma cells. Cutaneous infiltrates of B-cell chronic lymphocytic leukemia (B-CLL) may accumulate at sites of infection, including Borrelia infection. We report an unusual constellation in a patient with synchronously diagnosed B-CLL and Borrelia infection of skin presenting with a dense dermal T-cell-rich infiltrate masking specific leukemic infiltrates of neoplastic B cells in the context of B-CLL harboring t(14;18)(q32;q21). Specific cutaneous involvement by B-CLL was confirmed by the detection of t(14;18)(q32;q21) (BCL2-IGH) using FISH in neoplastic B cells within the skin infiltrates. Borrelia burgdorferi (sensu lato) DNA detected by nested polymerase chain reaction in the skin biopsy and serological findings proved Borrelia infection. Complete resolution of the cutaneous infiltrates was observed after antibiotic treatment. This case demonstrates that Borrelia infection of the skin may present with dense T-cell-rich infiltrates mimicking cutaneous T-cell lymphoma and masking the synchronous presence of neoplastic B cells in the context of B-CLL.

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Lobular Panniculitis due to Borrelia burgdorferi Infection Mimicking Subcutaneous Panniculitis-Like T-Cell Lymphoma

Cited by 19 publications

References 22 publications

Septolobular panniculitis in disseminated Lyme borreliosis

Septolobular panniculitis in disseminated Lyme borreliosis

Subcutaneous panniculitis-like T-cell lymphoma in children: a detailed clinicopathological description of 11 multifocal cases with a high frequency of haemophagocytic syndrome

Cutaneous Borreliosis With a T-Cell–Rich Infiltrate and Simultaneous Involvement by B-Cell Chronic Lymphocytic Leukemia With t(14;18)(q32;q21)

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