J Korean Ophthalmol Soc.  2013 Apr;54(4):645-650. 10.3341/jkos.2013.54.4.645.

A Case of Lymphomatoid Papulosis of the Eyelid

• Choi YJ
• Jin HC
• Kim NJ
• Choung HK
• Khwarg SI

• KMID: 2216947
• DOI: http://doi.org/10.3341/jkos.2013.54.4.645

Abstract

PURPOSE
Lymphomatoid papulosis (LyP) is one of the primary cutaneous CD30-positive lymphoproliferative disorders. LyP of the eyelid has rarely been reported. Herein, a case of typical LyP of the medial canthal area is reported. In addition, a literature review was performed.
CASE SUMMARY
A 40-year-old female presented with a skin mass in the medial canthal area of the left eye that developed 2 months earlier. Initially, a focal skin lesion developed, and even with conservative treatment at a local clinic, progressed to a mass lesion having a central ulceration and adjacent edema. After 6 weeks, the adjacent edema had gradually decreased. On ophthalmic examination, the left medial canthal lesion was a 6 x 6 mm sized elevated mass with a central crater covered by crust. The clinical impression was keratoacanthoma. The lesion was widely excised and reconstructed by a full-thickness skin graft after an incisional biopsy. Histopathologic findings showed dermal infiltration of various inflammatory cells with atypical lymphocytes showing positivity to the CD30 antigen, and LyP was diagnosed. Systemic evaluation showed no evidence of systemic lymphoma and the patient has remained free of recurrence or systemic disease after a 1-year follow-up.

Keyword

CD30 lymphoproliferative disease; Eyelid; Lymphomatoid papulosis

MeSH Terms

Antigens, CD30
Biopsy
Edema
Eye
Eyelids
Female
Follow-Up Studies
Humans
Keratoacanthoma
Lymphocytes
Lymphoma
Lymphomatoid Papulosis
Lymphoproliferative Disorders
Recurrence
Skin
Transplants
Ulcer
Antigens, CD30

Figure

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  Figure 1. (A) An 6 × 6 mm sized dome shaped nodule with central crater covered by crust was observed in the left me-dial canthal area. (B) This lesion was thought to be a keratoacanthoma at first visit in our clinic.

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  Figure 2. (A) The histopathological finding shows perivascular and dense dermal infiltration of inflammatory cells and some large atypical lymphocytes (H&E, ×;200). (B) High magnification shows large atypical lymphocytes with prom inent nucleoli forming an infiltrate in lymphomatoid papulosis (H&E, ×;400). (C-E) On immunohistochemical stains, the dermal infiltrates are composed of lymphocytes expressing CD 30, CD4 and CD 3 positive cells (×;400).

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  Figure 3. (A) Postoperative photo; one year after excision of medial canthal mass and reconstruction of skin defect by full-thickness skin graft from left retroauricular area. (B) This photo shows the lesion in more detail.

Reference

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