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Dermoscopic Features of CD8-Positive Solitary Pagetoid Reticulosis on the Left Leg.

Suzaki R, Kobayashi K, Ishizaki S, Fujibayashi M, Tanaka M - Dermatol Res Pract (2010)

Bottom Line: We reported a 57-year-old Japanese woman who presented with a 1-year history of a solitary erythematous plaque on the left leg.Dermoscopic features simulated Bowen's disease showing dotted and glomerular vessels, whitish scaly areas, and a broad negative network.We have discussed the diagnostic significance of the observed dermoscopic findings.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Tokyo Women's Medical University, Medical Center East, 2-1-10 Nishi-Ogu, Arakawa-Ku, Tokyo 116-8567, Japan.

ABSTRACT
Solitary pagetoid reticulosis, also known as Woringer-Kolopp disease, is a rare subtype of cutaneous T-cell lymphoma. The typical clinical presentation is a solitary, localized psoriasiform or hyperkeratotic plaque or tumor located on the extremities. It primarily affects middle-aged males. Because the clinical features of pagetoid reticulosis are indistinctive, pagetoid reticulosis may progress for years before accurate diagnosis. We reported a 57-year-old Japanese woman who presented with a 1-year history of a solitary erythematous plaque on the left leg. Dermoscopic features simulated Bowen's disease showing dotted and glomerular vessels, whitish scaly areas, and a broad negative network. Dermoscopic features of pagetoid reticulosis have never been reported. We have discussed the diagnostic significance of the observed dermoscopic findings.

No MeSH data available.


Related in: MedlinePlus

(a) A solitary slightly palpable scaly erythema on the left leg. (b) The lesion is sharply marginated with a scaly surface. (c) The dermoscopic examination demonstrated dotted and glomerular vessels with a homogenous pinkish background. A broad and indistinct whitish negative network is seen at the periphery.
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fig1: (a) A solitary slightly palpable scaly erythema on the left leg. (b) The lesion is sharply marginated with a scaly surface. (c) The dermoscopic examination demonstrated dotted and glomerular vessels with a homogenous pinkish background. A broad and indistinct whitish negative network is seen at the periphery.

Mentions: A 57-year-old Japanese woman presented with a 1-year history of a solitary erythematous plaque on the left leg (Figures 1(a) and 1(b)). She had been treated with topical corticosteroid for a year without any improvement. The physical examination revealed a solitary erythematous plaque with a scaly surface measuring 17 × 14 mm in diameter. The dermoscopic examination demonstrated dotted and glomerular vessels with a homogenous pinkish background and whitish scaly areas. At the periphery of the lesion, there is a whitish negative network simulating Bowen's disease (Figure 1(c)). However, as compared with Bowen's disease, the glomerular vessels are less prominent and the negative network is broader and more obscure. The whitish scaly areas are also less conspicuous. The histopathological examination of an excisional biopsy disclosed massive band-like infiltrates of atypical lymphocytes with prominent epidermotropism within a hyperplastic epidermis (Figures 2(a) and 2(b)). Atypical lymphocytes were positively stained with CD3 and predominantly with CD8, but negative with CD4, CD20, CD30, and CD79a. Based on histopathologic and immunohistochemical findings, a diagnosis of solitary pagetoid reticulosis was established. No evidence of metastatic lesions has been shown by brain MR imaging and chest and abdominal CT. We performed a successful operation for residual erythematous plaque with a 5 mm margin. The patient is doing well after the operation for 4 months with no recurrence or lymph node swelling.


Dermoscopic Features of CD8-Positive Solitary Pagetoid Reticulosis on the Left Leg.

Suzaki R, Kobayashi K, Ishizaki S, Fujibayashi M, Tanaka M - Dermatol Res Pract (2010)

(a) A solitary slightly palpable scaly erythema on the left leg. (b) The lesion is sharply marginated with a scaly surface. (c) The dermoscopic examination demonstrated dotted and glomerular vessels with a homogenous pinkish background. A broad and indistinct whitish negative network is seen at the periphery.
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC2913809&req=5

fig1: (a) A solitary slightly palpable scaly erythema on the left leg. (b) The lesion is sharply marginated with a scaly surface. (c) The dermoscopic examination demonstrated dotted and glomerular vessels with a homogenous pinkish background. A broad and indistinct whitish negative network is seen at the periphery.
Mentions: A 57-year-old Japanese woman presented with a 1-year history of a solitary erythematous plaque on the left leg (Figures 1(a) and 1(b)). She had been treated with topical corticosteroid for a year without any improvement. The physical examination revealed a solitary erythematous plaque with a scaly surface measuring 17 × 14 mm in diameter. The dermoscopic examination demonstrated dotted and glomerular vessels with a homogenous pinkish background and whitish scaly areas. At the periphery of the lesion, there is a whitish negative network simulating Bowen's disease (Figure 1(c)). However, as compared with Bowen's disease, the glomerular vessels are less prominent and the negative network is broader and more obscure. The whitish scaly areas are also less conspicuous. The histopathological examination of an excisional biopsy disclosed massive band-like infiltrates of atypical lymphocytes with prominent epidermotropism within a hyperplastic epidermis (Figures 2(a) and 2(b)). Atypical lymphocytes were positively stained with CD3 and predominantly with CD8, but negative with CD4, CD20, CD30, and CD79a. Based on histopathologic and immunohistochemical findings, a diagnosis of solitary pagetoid reticulosis was established. No evidence of metastatic lesions has been shown by brain MR imaging and chest and abdominal CT. We performed a successful operation for residual erythematous plaque with a 5 mm margin. The patient is doing well after the operation for 4 months with no recurrence or lymph node swelling.

Bottom Line: We reported a 57-year-old Japanese woman who presented with a 1-year history of a solitary erythematous plaque on the left leg.Dermoscopic features simulated Bowen's disease showing dotted and glomerular vessels, whitish scaly areas, and a broad negative network.We have discussed the diagnostic significance of the observed dermoscopic findings.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Tokyo Women's Medical University, Medical Center East, 2-1-10 Nishi-Ogu, Arakawa-Ku, Tokyo 116-8567, Japan.

ABSTRACT
Solitary pagetoid reticulosis, also known as Woringer-Kolopp disease, is a rare subtype of cutaneous T-cell lymphoma. The typical clinical presentation is a solitary, localized psoriasiform or hyperkeratotic plaque or tumor located on the extremities. It primarily affects middle-aged males. Because the clinical features of pagetoid reticulosis are indistinctive, pagetoid reticulosis may progress for years before accurate diagnosis. We reported a 57-year-old Japanese woman who presented with a 1-year history of a solitary erythematous plaque on the left leg. Dermoscopic features simulated Bowen's disease showing dotted and glomerular vessels, whitish scaly areas, and a broad negative network. Dermoscopic features of pagetoid reticulosis have never been reported. We have discussed the diagnostic significance of the observed dermoscopic findings.

No MeSH data available.


Related in: MedlinePlus