Oral manifestation of lymphomatoid papulosis: systematic review

Abstract

Introduction: Lymphomatoid Papulosis (LyP) is a lymphoproliferative disorder with typical histopathological criteria and a spontaneous regression. Only few cases of oral involvement have been reported. We wondered about their clinical characteristics and their association with lymphoma. Method: This systematic review is conducted according to the PRISMA statement. The Oxford Centre for Evidence Based Medicine table (OCEBM) and the scoring from the National Agency for Accreditation and Assessment in Health (ANAES) was assigned to each study. Results: We have included 16 references. LyP can occur at any age with a female predilection. Oral lesions were unique ulcer and tongue was mostly affected. Histological types A, and C were dominant and LyP resolved spontaneously. 1 case was associated with a lymphoma. Discussion: Cutaneous LyP more affects men and are mostly classified as type A while those orals are type A or C. Oral LyP is probably a progressive lesion whose evolution is not illustrated by the histological aspect which often reflects only the initial acute period. Conclusion: Our literature review has shown that the epidemiological aspects between oral and cutaneous LyP are not the same. LyP may be associated with an increased risk of developing systemic lymphoproliferative disorders.

Lymphomatoid Papulosis “Type E” Affecting the Palate: A Detailed Case Report and Review of Literature

“…4–6 LyP with DUSP22/IRF4 rearrangement shows an epidermotropic infiltrate of weakly positive CD30 small atypical lymphoid cells and dermal infiltrate of strongly positive CD30 large blast cells, with variable CD8 expression. 1,6…”

“…4,5 LyP type B (,5%) shows infiltrates of small-to medium-sized atypical lymphoid cells with variable expression of CD30, simulating early stage mycosis fungoides. 5,6 In LyP type C (10%), a dense infiltrate of sheets of CD30 + pleomorphic cells is present 4,5 . The CD4 + /CD8phenotype is predominant in A, B, and C types.…”

“…Typically, the lesions rapidly evolve into larger ulcerations, presenting a necrotic, eschar-like appearance. [1][2][3]6 The designation "E" reflects the most typical feature of the lesion, namely escharlike (hence, type E) ulcers. By microscopy, angioinvasive and angiodestructive infiltrate of CD30 + /CD8 + small-to mediumsized atypical lymphoid cells, frequently expressing cytotoxic markers, is typically observed.…”

“…6 LyP type D (,5%) exhibits a predominant epidermotropic infiltrate of CD30 + /CD8 + small-to medium-sized atypical lymphoid cells. [4][5][6] LyP with DUSP22/IRF4 rearrangement shows an epidermotropic infiltrate of weakly positive CD30 small atypical lymphoid cells and dermal infiltrate of strongly positive CD30 large blast cells, with variable CD8 expression. 1,6 In LyP type E (,5%), cutaneous lesions were more frequent than oral mucosal lesions (ratio 8:1).…”

“…[4][5][6] LyP with DUSP22/IRF4 rearrangement shows an epidermotropic infiltrate of weakly positive CD30 small atypical lymphoid cells and dermal infiltrate of strongly positive CD30 large blast cells, with variable CD8 expression. 1,6 In LyP type E (,5%), cutaneous lesions were more frequent than oral mucosal lesions (ratio 8:1). Typically, the lesions rapidly evolve into larger ulcerations, presenting a necrotic, eschar-like appearance.…”