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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Cutaneous Pseudolymphoma &#40;CPL&#41; refers to reactive lymphoid proliferation simulating cutaneous lymphomas&#46; CPL may occur in response to many kinds of foreign antigens or factors&#44; such as injected substances&#44; tattoos&#44; arthropod bites&#44; and so on&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> However&#44; in many cases&#44; the reasons cannot be identified&#44; hence the term idiopathic CPL&#46; CPL has various clinical presentations&#44; usually including red plaques&#44; papules&#44; and nodules&#46; Herein&#44; we report a case of idiopathic CPL with subcutaneous nodules on the back&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 31-year-old man presented with a 3-month history of two asymptomatic subcutaneous nodules on his back&#46; He was otherwise healthy and there was no history of preceding illness&#44; injected substances&#44; vaccination&#44; or insect bite&#46; Physical examination revealed two coin-sized subcutaneous nodules palpable on his back &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The skin overlying the nodules was normal&#46; There was no lymphadenopathy or hepatosplenomegaly&#46; The supposed clinical diagnosis of the nodules was lipoma before the biopsy&#46; Tests for HBsAg&#44; anti-HCV antibody&#44; anti-HIV antibody&#44; and syphilis antibody were negative&#46; Chest&#44; abdominal and pelvic CT did not reveal any abnormality&#46; The biopsy specimen taken from a subcutaneous nodule showed lymphocytic nodular infiltrate with several reactive germinal centers&#44; extending into subcutaneous fat &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>a&#41;&#46; Some nuclei between the follicles were large and mildly irregular &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>b&#41;&#46; Immunohistochemistry demonstrated positive for CD3&#44; CD4&#44; CD8&#44; CD20&#44; CD138&#44; KAPPA &#40;few and scattered&#41;&#44; LAMBDA &#40;few and scattered&#41;&#44; Ki67 &#40;presented a level proliferation index of about 15&#37;&#41;&#44; and negative for CD30&#46; CD21 expression exhibited atrophic follicular dendritic cell network &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; Polymerase chain reaction amplification showed polyclonality for immunoglobulin heavy chain and T-cell gamma chain gene rearrangements&#46; Based on the above findings&#44; a diagnosis of idiopathic CPL was rendered&#46; The patient received surgical therapy&#46; In the following-up seven years&#44; the lesions did not reappear&#44; and the patient was healthy&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Cutaneous Pseudolymphoma &#40;CPL&#41; is not an uncommon condition&#44; which considers a group of benign cutaneous lymphoproliferative disorders and very rarely progresses to lymphoma&#46; The clinical presentation of CPL has a wide spectrum&#46; The most common clinical manifestations are red to violaceous nodules&#44; papules&#44; or plaques on the exposed areas&#44; especially on the face and neck&#46; Subcutaneous nodules&#44; as in our case&#44; are the uncommon presentation of CPL&#44; which have been described in several cases occurring secondary to feline scratches or injection of vaccines&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;4</span></a> In addition&#44; the lesions in previous cases are all on extremities&#44; especially upper arms&#46; However&#44; an etiology cannot be identified in our case&#44; and the subcutaneous nodules are on the back&#46; To our knowledge&#44; this is the first report of idiopathic CPL with subcutaneous nodules on the back&#46; CPL may resolve spontaneously or persist indefinitely&#46; There are no specific treatments for CPL&#46; Present therapeutic approaches include surgical excision&#44; photodynamic therapy&#44; interferon&#44; radiotherapy&#44; topical corticosteroids&#44; and so on&#46; Despite a relatively good prognosis&#44; a few CPL can progress to lymphoma&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> so a long-term follow-up is indispensable&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0020" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors&#8217;s contributions</span><p id="par0025" class="elsevierStylePara elsevierViewall">Ying Wang&#58; Approval of final version of the manuscript&#59; conception and planning of the study&#59; drafting and editing of the manuscript&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Sitong Li&#58; Approval of final version of the manuscript&#59; participation in the design of the study&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Yanping Bai&#58; Approval of final version of the manuscript&#59; conception and planning of the study&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Zhancai Zheng&#58; Approval of final version of the manuscript&#59; conception and planning of the study&#59; drafting and editing of the manuscript&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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Case Letter
An unusual presentation of cutaneous pseudolymphoma
Ying Wang, Sitong Li, Yanping Bai, Zhancai Zheng
Corresponding author
drzhengzhancai@163.com

Corresponding author.
Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Cutaneous Pseudolymphoma &#40;CPL&#41; refers to reactive lymphoid proliferation simulating cutaneous lymphomas&#46; CPL may occur in response to many kinds of foreign antigens or factors&#44; such as injected substances&#44; tattoos&#44; arthropod bites&#44; and so on&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> However&#44; in many cases&#44; the reasons cannot be identified&#44; hence the term idiopathic CPL&#46; CPL has various clinical presentations&#44; usually including red plaques&#44; papules&#44; and nodules&#46; Herein&#44; we report a case of idiopathic CPL with subcutaneous nodules on the back&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 31-year-old man presented with a 3-month history of two asymptomatic subcutaneous nodules on his back&#46; He was otherwise healthy and there was no history of preceding illness&#44; injected substances&#44; vaccination&#44; or insect bite&#46; Physical examination revealed two coin-sized subcutaneous nodules palpable on his back &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The skin overlying the nodules was normal&#46; There was no lymphadenopathy or hepatosplenomegaly&#46; The supposed clinical diagnosis of the nodules was lipoma before the biopsy&#46; Tests for HBsAg&#44; anti-HCV antibody&#44; anti-HIV antibody&#44; and syphilis antibody were negative&#46; Chest&#44; abdominal and pelvic CT did not reveal any abnormality&#46; The biopsy specimen taken from a subcutaneous nodule showed lymphocytic nodular infiltrate with several reactive germinal centers&#44; extending into subcutaneous fat &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>a&#41;&#46; Some nuclei between the follicles were large and mildly irregular &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>b&#41;&#46; Immunohistochemistry demonstrated positive for CD3&#44; CD4&#44; CD8&#44; CD20&#44; CD138&#44; KAPPA &#40;few and scattered&#41;&#44; LAMBDA &#40;few and scattered&#41;&#44; Ki67 &#40;presented a level proliferation index of about 15&#37;&#41;&#44; and negative for CD30&#46; CD21 expression exhibited atrophic follicular dendritic cell network &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; Polymerase chain reaction amplification showed polyclonality for immunoglobulin heavy chain and T-cell gamma chain gene rearrangements&#46; Based on the above findings&#44; a diagnosis of idiopathic CPL was rendered&#46; The patient received surgical therapy&#46; In the following-up seven years&#44; the lesions did not reappear&#44; and the patient was healthy&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Cutaneous Pseudolymphoma &#40;CPL&#41; is not an uncommon condition&#44; which considers a group of benign cutaneous lymphoproliferative disorders and very rarely progresses to lymphoma&#46; The clinical presentation of CPL has a wide spectrum&#46; The most common clinical manifestations are red to violaceous nodules&#44; papules&#44; or plaques on the exposed areas&#44; especially on the face and neck&#46; Subcutaneous nodules&#44; as in our case&#44; are the uncommon presentation of CPL&#44; which have been described in several cases occurring secondary to feline scratches or injection of vaccines&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;4</span></a> In addition&#44; the lesions in previous cases are all on extremities&#44; especially upper arms&#46; However&#44; an etiology cannot be identified in our case&#44; and the subcutaneous nodules are on the back&#46; To our knowledge&#44; this is the first report of idiopathic CPL with subcutaneous nodules on the back&#46; CPL may resolve spontaneously or persist indefinitely&#46; There are no specific treatments for CPL&#46; Present therapeutic approaches include surgical excision&#44; photodynamic therapy&#44; interferon&#44; radiotherapy&#44; topical corticosteroids&#44; and so on&#46; Despite a relatively good prognosis&#44; a few CPL can progress to lymphoma&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> so a long-term follow-up is indispensable&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0020" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors&#8217;s contributions</span><p id="par0025" class="elsevierStylePara elsevierViewall">Ying Wang&#58; Approval of final version of the manuscript&#59; conception and planning of the study&#59; drafting and editing of the manuscript&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Sitong Li&#58; Approval of final version of the manuscript&#59; participation in the design of the study&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Yanping Bai&#58; Approval of final version of the manuscript&#59; conception and planning of the study&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Zhancai Zheng&#58; Approval of final version of the manuscript&#59; conception and planning of the study&#59; drafting and editing of the manuscript&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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Article information
ISSN: 03650596
Original language: English
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