Persistent cutaneous pseudolymphoma after intradermal gold injection

Kalimo, Kirsti; Räsänen, L; Aho, Heikki; Mäki, Jouko; Mustikka-Mäki, Urho Pekka; Rantala, Immo

doi:10.1111/j.1600-0560.1996.tb01306.x

Cited by 29 publications

(23 citation statements)

References 28 publications

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“…Since then, several similar cases to various antigens have been reported 16–21 . A similar entity has been reported after antigen injections for desensitization purposes 15,22 , 23 and after gold injections 24 . Our patient had strongly positive patch tests for a series of allergens in the topical treatments applied during the 6 months prior to initial consultation.…”

Section: Discussionsupporting

confidence: 73%

Cutaneous pseudolymphoma, lymphomatoid contact dermatitis type, as an unusual cause of symmetrical upper eyelid nodules

Braun

French

Feldmann

et al. 2000

British Journal of Dermatology

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We describe a 74-year-old woman who rapidly developed bilateral voluminous nodules on the upper eyelids, following 4 months' treatment for chalazion. Histological and immunohistochemical findings were suggestive of cutaneous pseudolymphoma (CPL), and extensive screening for malignant lymphoma (ML) remained negative. Cutaneous pseudolymphomas are inflammatory diseases that can simulate ML either clinically, histopathologically, or both. They are a rare cause of nodules of the upper eyelids, usually characterized by a benign evolution, that can be secondary to ultraviolet sensitivity, adverse reactions to systemic medications and contact sensitization, among others. In our case, epicutaneous patch tests were strongly positive for a series of allergens contained in the ophthalmological preparations used; therefore, they were suggestive that the patient had CPL, lymphomatoid contact dermatitis type. In addition, the patient had been treated previously with several drugs, known to cause CPL and immune dysregulation. Complete regression of the lesions required treatment with systemic steroids and chlorambucil. No relapse occurred within a 5-year follow-up period.

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Section: Discussionsupporting

confidence: 73%

Cutaneous pseudolymphoma, lymphomatoid contact dermatitis type, as an unusual cause of symmetrical upper eyelid nodules

Braun

French

Feldmann

et al. 2000

British Journal of Dermatology

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“…LC is the stereotypical example of the cutaneous B‐cell pseudolymphomas 1,2 , 14 . It has been described in association with various antigenic stimuli including arthropod bites, 3 ingestion of drugs, 5 allergy hyposensitization injections or vaccination, 4 chronic infections, 15 cobalt, 16 gold, 17,18 tattoo pigment, 19,20 and treatment with leeches ( Hirudo medicinalis ) 21 . Cases reported in the past as pseudolymphoma occurring at the sites of previous herpes zoster infection 22,23 in patients with chronic lymphocytic leukemia probably represent for the most part specific cutaneous infiltrates by leukemic cells 24 .…”

Section: Discussionmentioning

confidence: 99%

Borrelia burgdorferi‐associated lymphocytoma cutis: clinicopathologic, immunophenotypic, and molecular study of 106 cases

et al. 2004

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Lymphocytoma cutis (LC) is considered as the stereotypical example of the cutaneous B-cell pseudolymphomas. It can be induced by various antigenic stimuli including arthropod bites, vaccination, and drugs among others. In endemic regions, Borrelia burgdorferi is the principal causative agent for LC. We studied retrospectively 108 biopsies from 106 patients (male : female, 48 : 58; mean age, 44.6; median, 51.5; range, 3-81) with B. burgdorferi-associated LC retrieved from the files of the Department of Dermatology of the University of Graz (Austria). Only cases with a B. burgdorferi etiology (typical locations, positivity of serologic and/or polymerase chain reaction (PCR) tests, clinical history) were included in the study. Lesions were located on the nipple (63 cases), earlobe (18 cases), genital region (9 cases), and trunk or extremities (16 cases). PCR analysis of B. burgdorferi DNA was positive in 54 of 80 cases tested (67.5%). In 47 cases, we could retrieve data on serologic examination for B. burgdorferi antibodies performed at the time of diagnosis of LC. Positivity was found in 45 patients (IgG+/IgM+, 5 cases; IgG+/IgM-, 37 cases; IgG-/IgM+, 3 cases; IgG-/IgM-, 2 cases). Histology revealed dense lymphoid infiltrates with prominent germinal centers (GCs) in all cases. Atypical morphologic and/or immunophenotypic features of the GCs were commonly observed. In 5 cases, due to confluence of large follicles, the histopathologic pattern simulated that of a large B-cell lymphoma. PCR analysis of the IgH gene rearrangement performed in 33 cases showed a polyclonal pattern in 31 cases and a monoclonal band in 2. In summary, B. burgdorferi-associated LC can present with misleading histopathologic, immunophenotypic, and molecular features, and integration of all data is necessary for a correct diagnosis.

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“…The corrosion process generates ionically active species that induce the immune system response . Kalimo et al showed how small gold particles appeared to bind persistently in the skin after intradermal tests, and accumulated in the macrophages of susceptible individuals, inducing pseudolymphoma formation . Two cases related to gold earrings have been reported so far .…”

Section: Discussionmentioning

confidence: 99%

“…Although spontaneous regression has been described, a follow‐up of at least 5 years is required to rule out the risk of cutaneous lymphomas. The specific risk of conversion of gold‐related pseudolymphoma has not been studied …”

Section: Discussionmentioning

confidence: 99%