A Case of Lymphomatoid Papulosis Type E With an Unusual Exacerbated Clinical Course.
A Case of Lymphomatoid Papulosis Type E With an Unusual Exacerbated Clinical Course.
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E 型淋巴瘤样丘疹病一例，临床病程异常恶化。
DOI：
10.1097/dad.0000000000000970
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
D. Kazakov
中科院分区：
文献类型：
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作者：
I. Belousova;Liubov Kyrpychova;A. Samtsov;D. Kazakov
淋巴瘤样丘疹病（LyP）E型是一种最近描述的变异，其特征是发生大的坏死性“焦痂”样病变，在显微镜下显示由CD30淋巴细胞组成的血管浸润性和血管破坏性浸润，经常共表达CD8。与其他LyP变体患者发生多处病变相反，大多数E型LyP患者出现很少的病变（通常在给定时间1或2个）。在这篇文章中，我们描述了一个34岁的男子与LyP E型与恶化的临床过程的特点是发生了近一百个病变。最初，他提出了一个单一的快速增长的2厘米大结节的前臂，但多西环素给药后，多焦痂样病变全身发展。在组织病理学上观察到非典型淋巴浸润，具有明显的血管中心性和CD30中型至大型多形性淋巴细胞的血管向性。停用抗生素后，病变自行消退。认识这种罕见的LyP变异及其正确识别，即使临床过程是不寻常的和令人担忧的，是重要的，以避免积极的治疗。
Lymphomatoid papulosis (LyP) type E is a recently delineated variant characterized by the occurrence of large necrotic "eschar"-like lesions displaying microscopically angioinvasive and angiodestructive infiltrates composed of CD30 lymphocytes, frequently coexpressing CD8. In contrast to other LyP variants where patients develop multiple lesions, most patients with LyP type E present with few lesions (often 1 or 2 at a given time). In this article, we describe a 34-year-old man with LyP type E with an exacerbated clinical course characterized by the occurrence of almost a hundred of lesions. Initially, he presented with a single rapidly growing 2-cm large erythematous nodule on the forearm but after the administration of doxycycline multiple eschar-like lesions developed all over the body. Atypical lymphoid infiltrates with marked angiocentricity and angiotropism of CD30 medium-sized to large pleomorphic lymphocytes were seen histopathologically. After the withdrawal of the antibiotic, the lesions spontaneously regressed. Awareness of this rare LyP variant and its correct recognition, even if the clinical course is unusual and worrisome, is important to avoid aggressive treatment.