Choi Myoung Eun, Lee Keon Hee, Lim Dong Jun, Won Chong Hyun, Chang Sung Eun, Lee Mi Woo, Choi Jee Ho, Lee Woo Jin
Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
J Clin Med. 2020 Apr 23;9(4):1217. doi: 10.3390/jcm9041217.
Cutaneous lymphoid hyperplasia (CLH) is a heterogeneous type of reactive lymphocytic infiltration resembling cutaneous lymphoma clinically and histopathologically. Few studies describe the relationship between the causative agents and histopathological and immunohistochemical characteristics of CLH. We investigated the clinical and histopathological characteristics of 50 patients with cutaneous CLH and analyzed them according to causative factors and predominant cell types (B or T cells). We retrospectively reviewed medical records to identify causative agents, and histopathological and immunohistochemical features. The majority of infiltrating lymphocytes were T cells (60%). T cell-dominant CLH showed papuloplaque lesions, whereas B cell-dominant CLH lesions were nodular. The infiltration pattern differed between T and B cells. In terms of prognosis, B-cell-predominant lesions tended to respond better to treatment than T-cell-predominant lesions. Hair dyes tended to be associated with multiple CLH lesions in older patients. CLH lesions associated with drugs were located on the head and neck. Insect bites were likely to cause a solitary papular lesion. Histopathologically, infiltration depth was located more superficially than other causes and featured intense eosinophilic infiltration. Thus, our study demonstrated that CLH presents different clinicopathological features according to causative agents and predominant lymphocytic types.
皮肤淋巴细胞增生症（CLH）是一种异质性的反应性淋巴细胞浸润，在临床和组织病理学上类似于皮肤淋巴瘤。很少有研究描述CLH的致病因素与组织病理学及免疫组化特征之间的关系。我们调查了50例皮肤CLH患者的临床和组织病理学特征，并根据致病因素和主要细胞类型（B细胞或T细胞）进行分析。我们回顾性查阅病历以确定致病因素、组织病理学和免疫组化特征。大多数浸润淋巴细胞为T细胞（60%）。T细胞为主的CLH表现为丘疹斑块性病变，而B细胞为主的CLH病变为结节状。T细胞和B细胞的浸润模式不同。在预后方面，B细胞为主的病变往往比T细胞为主的病变对治疗反应更好。染发剂往往与老年患者的多处CLH病变有关。与药物相关的CLH病变位于头颈部。昆虫叮咬很可能导致孤立的丘疹性病变。组织病理学上，浸润深度比其他病因更表浅，且有强烈的嗜酸性粒细胞浸润。因此，我们的研究表明，CLH根据致病因素和主要淋巴细胞类型呈现出不同的临床病理特征。
