Concluded Case

LYMPHOMATOID PAPULOSIS

18-years female presented with multiple erythematous papules, plaques, hemorrhagic ulcerations, and atrophic scars for 15 years. She had occasional bouts of fever and weakness. No lymphadenopathy. Skin biopsy showed a dense dermal infiltrate of pleomorphic atypical lymphocytes with destruction of blood vessels. Lymphocytes which were predominantly CD30 +, and mostly CD8+ lymphoid cells. CD20, CD56, and CD21 were negative. What is the probable diagnosis on the following? Leprosy Lymphomatoid papulosis Sarcoidosis Secondary syphilis Leishmaniasis

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Yes it's LYMPHOMATOID PAPULOSIS it is chronic, recurrent papulonodular skin eruption with histologic features of malignant lymphoma . It is characterized by chronic recurrent, self-healing papulonodules, which rapidly turn into hemorrhagic necrotic ulcers and spontaneous regression by leaving a scar. The lesions of LyP are grouped or generalized and usually coexist in different developmental stages .The lesions of LyP are generally smaller than 2 cm; larger lesions are occasionally seen . Mucous membranes (eg, oral or vaginal mucosa), are rarely involved.B symptoms (Fever,Night sweats and weight loss) are generally absent. Monoclonal rearrangement of the T cell receptor (TCR) genes has been detected in 40 to 100 percent of the LyP skin lesions. Approximately 10% to 20% of patients with LyP may present with a lymphoproliferative malignancy such as CD30 anaplastic large cell lymphoma (ALCL), mycosis fungoides (MF), or Hodgkin disease None of the available treatment modalities affects the natural course of LyP. Wait-and-see strategy (observation) for patients who have limited or asymptomatic disease without scarring. In most cases aggressive treatment is not required because of its favorable prognosis. Topical and systemic steroids, PUVA, low dose methotrexate, bexarotene, and IFN alfa-2b are known to be effective.

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Yes it's LYMPHOMATOID PAPULOSIS it is chronic, recurrent papulonodular skin eruption with histologic features of malignant lymphoma . It is characterized by chronic recurrent, self-healing papulonodules, which rapidly turn into hemorrhagic necrotic ulcers and spontaneous regression by leaving a scar. The lesions of LyP are grouped or generalized and usually coexist in different developmental stages .The lesions of LyP are generally smaller than 2 cm; larger lesions are occasionally seen . Mucous membranes (eg, oral or vaginal mucosa), are rarely involved.B symptoms (Fever,Night sweats and weight loss) are generally absent. Monoclonal rearrangement of the T cell receptor (TCR) genes has been detected in 40 to 100 percent of the LyP skin lesions. Approximately 10% to 20% of patients with LyP may present with a lymphoproliferative malignancy such as CD30 anaplastic large cell lymphoma (ALCL), mycosis fungoides (MF), or Hodgkin disease None of the available treatment modalities affects the natural course of LyP. Wait-and-see strategy (observation) for patients who have limited or asymptomatic disease without scarring. In most cases aggressive treatment is not required because of its favorable prognosis. Topical and systemic steroids, PUVA, low dose methotrexate, bexarotene, and IFN alfa-2b are known to be effective.

It may be Lymphomatoid papulosis with multiple flaccid bullae..

Test Allergies test Ige CBC Lft Lft T3 t4 tsh Then start treatment According to reports Temporary medicine used Antibiotic inj Pertmarthin lotion Antifungal

What are parents doing...at such a tender age...needs counselling calmness symphony music lime juice pineapple with black pepper sprouts kalijeeri alkaline diet no sugar no nonveg diet no eggs no mushrooms no fried foods no processed or fermented foods and beverages no vyasan pomegranat e muskmelon cucumber cherries berries apricots ginger garlic little onions walnuts blue berries sunshine ginger cherries berries garlic little.... flaxseeds... cold pressed coconut oil massage and in naval.. coconut water.... spinach salad beetroot coriander juice sweet potato corn cauliflower figs broccoli purple cabbage cabbage juice orange juice under strict supervision of Doctor inhalation techniques... traumatic..

Lymphomatoid papulosis... Immunotherapy..

Thank you doctor
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