Lymphocytoma cutis is not a specific disease. Rather, lymphocytoma cutis is a response to a variety of known and unknown stimuli that results in the accumulation of lymphocytes and other inflammatory cells in a localized region. Lymphocytoma cutis is known to simulate lymphoma, as reflected primarily by the histologic findings. However, lymphocytoma cutis is a reactive process and generally has a benign course. When known, the inciting agent should be included in the diagnosis. The term lymphocytoma cutis or pseudolymphoma without modification should be reserved for idiopathic cases. Note the images below.
![]() View Image | This example of lymphocytoma cutis shows a localized, erythematous-to-brown, ill-defined plaque. |
![]() View Image | Lymphocytoma cutis of the shoulder, composed of flesh-colored or erythematous nodules in small groups. |
![]() View Image | This photograph of lymphocytoma cutis caused by an arthropod bite shows an erythematous scaling patch of the scalp with localized secondary alopecia. |
Related eMedicine articles include Cutaneous B-Cell Lymphoma and Cutaneous T-Cell Lymphoma.
In lymphocytoma cutis, lymphocytes and other inflammatory cells are recruited to a localized area of the skin in response to known or unknown stimuli. Most cases of lymphocytoma cutis are idiopathic. Lymphocytoma cutis is not considered a lymphocytic response to malignancy.
Cases with known etiologies involve a reaction to tattoo dye, jewelry (especially gold), arthropod bites, medications, folliculitis, trauma, infections (ie, with Borrelia burgdorferi, molluscum contagiosum), vaccinations, and acupuncture.
A discrete subset of lymphocytoma cutis, borrelial lymphocytoma, occurs primarily in Europe, in areas in which the Ixodes ricinus tick is endemic. This form of the disease is a response to an infection due to Borrelia burgdorferi subsp afzelius that is transmitted by a tick bite.[1]
No data on US prevalence or incidence of lymphocytoma cutis are available.
No data are available. Lymphocytoma cutis is uncommon but not rare. A discrete subset of lymphocytoma cutis, borrelial lymphocytoma, occurs primarily in Europe, in areas in which the I ricinus tick is endemic.
Lymphocytoma cutis is not associated with mortality. Lymphocytoma cutis is rarely associated with morbidity other than minor pain or pruritus. It generally heals without scarring.
No racial predilection is noted for lymphocytoma cutis.
The female-to-male ratio in reported of lymphocytoma cutis cases is approximately 2:1.
Individuals of any age may be affected, but lymphocytoma cutis is most common in early adulthood.
Most cases of lymphocytoma cutis are idiopathic. Known inciting agents for lymphocytoma cutis include the following:
Lymphocytoma cutis must be differentiated from lymphoma. Most cases of lymphocytoma cutis have a nodular inflammatory infiltrate and can simulate B-cell lymphoma.[9] The key histologic features that suggest lymphocytoma cutis instead of lymphoma include the presence of a mixed infiltrate that includes histiocytes, eosinophils, and plasma cells, in addition to lymphocytes.[10] In lymphocytoma cutis, the infiltrate tends to be top-heavy, whereas most lymphomas are centered in the deep dermis or subcutis. Samples of lymphocytoma cutis typically have germinal centers and tingible body macrophages, as shown in the images below. Occasionally, large lymphoid cells may be present; however, they rarely dominate the histologic picture.
![]() View Image | A mixed inflammatory infiltrate with germinal centers is indicative of lymphocytoma cutis. |
![]() View Image | Well-developed lymphoid follicles in a background of mixed inflammatory cells with small lymphocytes are typical of lymphocytoma cutis. |
Immunohistochemical staining may also be useful and generally shows a mixed B- and T-cell population with a high MIB-1–positive proliferative index. Staining for kappa and lambda light chains reveals a polyclonal pattern. Fresh, unfixed tissue may be required for adequate assessment of kappa and/or lambda labeling. Some cases of lymphocytoma cutis have a T-cell histologic pattern. Changes include a bandlike infiltrate in the papillary dermis, which predominantly includes small lymphocytes with variable epidermotropism. Although these features mimic those of cutaneous T-cell lymphoma or mycosis fungoides, the clinical presentation is characteristic.[11]
Surgical removal or cryosurgery may be effective in some cases of lymphocytoma cutis.