Lymphomatoid papulosis types D and E: a multicentre series of the French Cutaneous Lymphomas Study Group

Background Lymphomatoid papulosis (LyP) type D (LyP D) and type E (LyP E) have recently been described in small series of cases or isolated case reports. Aim To further describe the clinical and histological features of LyP D and E based on a retrospective multicentre study. Methods The clinical and histopathological features of 29 patients with an initial diagnosis of LyP D or LyP E were retrospectively assessed using standardized forms. Results After exclusion of 5 cases, 24 patients (14 LyP D, 10 LyP E) were enrolled in the study. The median follow-up was 2.5 years (range 1 month to 13 years). LyP D was characterized by multiple recurrent self-regressing small papules that developed central erosion or necrosis, whereas LyP E presented as papulonodular lesions that rapidly evolved into necrotic eschar-like lesions > 10 mm in size. Epidermal changes were more frequent in LyP D, whereas dermal infiltrates were deeper in LyP E. Anaplastic cytology was rare and the DUSP22 rearrangement was never observed. Two patients (8%) had an associated cutaneous lymphoma. Conclusion LyP D and E have distinct clinical findings and may be associated with other cutaneous lymphomas.

Automated summary

Lymphomatoid papulosis (LyP) type D is characterized by recurrent small papules with central erosion or necrosis, while LyP E presents as papulonodular lesions evolving into large necrotic eschar-like lesions. Differences are also seen in epidermal and dermal infiltrates between the two types. Some cases may be associated with other cutaneous lymphomas.