© Our Dermatol Online 1.2015 62 Angiocentric lymphomatoid papulosis in a child: uncommon benign clinical entity with malignant histology Kanthilatha Pai, Sathish Pai 1 Department of Pathology, Kasturba Medical College, Manipal University, Manipal, India, 2 Department of Dermatology, Kasturba Medical College, Manipal University, Manipal, India Corresponding author: Dr. Sathish Pai, E-mail: drsbpai@yahoo.co.in ABSTRACT Lymphomatoid papulosis (LyP) is a rare form of chronic inflammatory skin disease with histologic features of a malignant lymphoma.It presents clinically with history of recurrent crops of pruritic papules that occur on the trunk and limbs that resolve spontaneously. We report an unusual case of angiocentric LyP in a 4 year old child and review the literature. Key words: Lymphomatoid papulosis; child; cutaneous lymphoma INTRODUCTION The term lymphomatoid papulosis originally was used by Macaulay in 1968 to describe “a self-healing rhythmical paradoxical eruption, histologically malignant but clinically benign” [1]. Awareness of this entity is important as the histological features may result in a mistaken diagnosis of malignant lymphoma, if clinical picture is not taken into account. Follow-up is essential as it can progress to malignant lymphoma in a subset of patients. CASE REPORT A 4 year old male child presented with itchy erythematous and skin colored papules over trunk, upper and lower limbs of 3 months duration (Fig. 1). There were few excoriated papules. The child did not have genital or web space lesions. There was no history of prior viral infection, drug intake etc. A clinical diagnosis of prurigo simplex was considered and a skin biopsy was taken. Histopathological examination revealed wedge shaped superficial and deep aggregates of atypical lymphoid cells with hyperchromatic nuclei and scanty cytoplasm, along Case Report How to cite this article: Pai K, Pai S. Angiocentric lymphomatoid papulosis in a child: uncommon benign clinical entity with malignant histology. Our Dermatol Online. 2015;6(1):62-64. Submission: 13.09.2014; Acceptance: 10.11.2014 DOI: 10.7241/ourd.20151.15 with few mononuclear Reed Sternberg like cells with prominent nucleoli, admixed with plasma cells and histiocytes. Folliculotropism of the lymphoid cells was noted (Figs 2 and 3). Angiocentric infiltration around dermal blood vessels with necrosis of blood vessel wall was seen (Fig. 4). The lymphoid cells were predominantly CD 3 positive with admixed CD 20 positive cells, while the large atypical cells stained positive for CD 3 and CD30 (Fig. 5). A diagnosis of Lymphomatoid papulosis was made based on the clinical and histopathological features. The patient’s informed consent was obtained. Prior to the study, patient gave written consent to the examination and biopsy after having been informed about the procedure. DISCUSSION Lymphomatoid papulosis (LyP) is a chronic inflammatory skin disease which can histologically be mistaken for malignant lymphoma. It presents clinically with recurrent crops of itchy papules that occur on the trunk and legs that heal spontaneously over 1-2 months leaving slightly depressed oval scars.