Kollipara Ramya, Hans Amneet, Hall John, Lisle Allison
University of Missouri-Kansas City School of Medicine.
Dermatol Online J. 2015 Aug 15;21(8):13030/qt9s15929m.
Primary cutaneous marginal zone lymphoma (PCMZL) is a low-grade malignant B-cell lymphoma that appears in the skin without any extracutaneous manifestations. Therapeutic mainstays for PCMZL have primarily included radiotherapy and surgery. Intralesional steroids have been found to resolve the lesions caused by PCMZL, but there is a dearth of literature regarding this therapy indicating that this is not a commonly favored treatment option.
We present a case of 60-year-old woman who presented with PCMZL on her right eyebrow. Three years later, after two courses of radiation and one relapse, the patient presented with new lesions on both arms, consistent once again with PCMZL. At this time, therapy with nine rounds of intralesional triamcinolone was attempted. After each round of triamcinolone, gradual improvement of the lesions was noted until complete resolution occurred.
This case reminds practitioners that intralesional corticosteroids can be effectively and safely used to treat localized PCMZL. Intralesional steroids are less invasive, cheaper, and easier to administer than the majority of other recommended therapies for PCMZL. Thus, although they are often overlooked, intralesional corticosteroids should be more often considered when developing a treatment plan for localized PCMZL.
原发性皮肤边缘区淋巴瘤（PCMZL）是一种低度恶性B细胞淋巴瘤，出现在皮肤且无任何皮肤外表现。PCMZL的主要治疗方法主要包括放疗和手术。已发现病灶内注射类固醇可消退由PCMZL引起的病变，但关于这种疗法的文献较少，表明这不是一种普遍青睐的治疗选择。
我们报告一例60岁女性，其右眉出现PCMZL。三年后，经过两个疗程的放疗且出现一次复发后，患者双臂出现新病灶，再次符合PCMZL表现。此时，尝试进行了九轮病灶内注射曲安奈德治疗。每轮注射曲安奈德后，均观察到病灶逐渐改善直至完全消退。
该病例提醒临床医生，病灶内注射皮质类固醇可有效且安全地用于治疗局限性PCMZL。与PCMZL的大多数其他推荐疗法相比，病灶内注射类固醇侵入性更小、成本更低且更易于给药。因此，尽管病灶内注射类固醇常常被忽视，但在制定局限性PCMZL的治疗方案时应更常考虑使用。
