On the issue of diagnosis and treatment of skin pseudolymphoma on the example of a clinical case

Pseudolymphomas of the skin are a heterogeneous group of diseases manifested by benign lymphoid infiltrates that clinically and/or histologically mimic skin lymphoma.

The group of pseudolymphomas of the skin includes actinic reticuloid, benign lymphocytoma of the skin, true pesvdolymphoma, postscabious lymphoplasia, lymphocytic reactions to insect bites, etc. The diagnosis of pseudolymphoma is based on anamnesis data (the presence of a provoking factor, with the exception of idiopathic pseudolymphomas), clinical picture (a single papule, less often a plaque localized in open areas of the upper half of the body ― the face: cheeks, nose, earlobes; scalp, upper extremities, chest), results histological, immunophenotypic studies, and with persistent persistence of rashes ― on the results of molecular biological studies.

The similarity of clinical and pathomorphological signs of pseudolymph with malignant lymphoproliferative processes creates significant diagnostic difficulties and requires a thorough examination with the involvement of pathologists and oncologists. Diagnostic difficulties are often the cause of erroneous or late detection of skin lymphoma, which negatively affects the prognosis of the disease. Treatment tactics are determined by the morphological variant of lymphoid infiltration, as well as the presence and nature of the provoking factor. The majority of idiopathic psvdolymph is successfully treated with systemic glucocorticosteroids, however, in the case of resistance to systemic glucocorticoids, recommendations on treatment tactics have not yet been developed. Prolonged, often recurrent course, as well as the possibility of transformation of the process into malignant lymphoma of the skin, requires long-term clinical observation of patients.

The case presented in the article confirms that the crucial importance for the successful diagnosis of pseudolymphoma lies in the analysis of anamnesis data, clinical picture, histological and immunohistochemical studies.