Cutaneous B-cell neoplasms mimicking granulomatous rosacea or rhinophyma

Aviv Barzilai, Hana Feuerman, Pietro Quaglino, Michael David, Meora Feinmesser, Marisa Halpern, Edit Feldberg, Carlo Tomasini, Hilla Tabibian-Keissar, Ninette Amarilgio, Emmilia Hodak

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Unlike T-cell neoplasms, B-cell lymphoproliferative disorders have a limited clinical spectrum of skin involvement. Cutaneous B-cell neoplasms mimicking rosacea or rhinophyma are rare. Observations: We described 12 patients with B-cell lymphoproliferative neoplasms presenting with a facial eruption clinically mimicking rosacea or rhinophyma. Eleven patients were women; ages ranged from 36 to 81 years. The clinical presentation included small papules on the nose and cheeks and around the eyes mimicking granulomatous rosacea; nodules on the nose, cheeks, chin, or forehead mimicking phymatous rosacea; or a combination of both. Three patients had preexisting erythematotelangiectatic rosacea and 1 had rhinophyma. Based on a clinicopathologic correlation and B-cell clonality analysis, the diagnosis was primary cutaneous follicular center B-cell lymphoma in 4 cases, primary cutaneous marginal zone lymphoma in 6, and skin involvement of chronic lymphocytic leukemia in 2. All patients had an indolent course as expected for their disease. Conclusions: Cutaneous involvement of B-cell neoplasms may mimic granulomatous rosacea or rhinophyma. This unusual clinical presentation is more common in women and appears in the setting of preexisting rosacea or as a new eruption. Proliferative B-cell disorders should be added to the differential diagnosis of symmetric papular or papulonodular eruptions of the face.

Original languageEnglish
Pages (from-to)824-831
Number of pages8
JournalArchives of Dermatology
Volume148
Issue number7
DOIs
StatePublished - Jul 2012

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