Institutional members access full text with Ovid®

Share this article on:

Acrodermatitis Chronica Atrophicans With Pseudolymphomatous Infiltrates

Tee, Shang-Ian MRCP*,†; Martínez-Escanamé, Marcela MD*; Zuriel, Daniel MD*,‡; Fried, Isabella MD*; Wolf, Ingrid MD*; Massone, Cesare MD*; Cerroni, Lorenzo MD*

The American Journal of Dermatopathology: May 2013 - Volume 35 - Issue 3 - p 338–342
doi: 10.1097/DAD.0b013e31826b7487
Original Study

Abstract: In this study, we describe the clinicopathologic features of pseudolymphomatous infiltrates found within lesions of acrodermatitis chronica atrophicans (ACA). We studied 11 patients (10 females, 1 male, age range 60–88 years). The diagnosis of ACA in all cases was confirmed by clinicopathologic correlation and positive serology for Borrelia. Histopathologic examination revealed prominent, pseudolymphomatous inflammatory cell infiltrates in all cases, with 2 distinct patterns. Eight of 11 cases showed a band-like lymphocytic infiltrate, exocytosis of lymphocytes and a fibrotic papillary dermis, similar to features seen in mycosis fungoides. The other 3 cases showed dense, nodular-diffuse dermal infiltrates with many plasma cells and without germinal centers. The plasma cells expressed both kappa and lambda immunoglobulin light chains with a polyclonal pattern in all 3 cases. In conclusion, ACA may present with pseudolymphomatous infiltrates showing both a T-cell and, less frequently, a B-cell pattern. These lesions need to be distinguished from a cutaneous lymphoma. In the context of the knowledge of Borrelia-associated cutaneous lymphomas, follow-up seems advisable in these cases.

*Research Unit of Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria

National Skin Centre, Singapore

Department of Human Pathology, School of Medicine, University of Nairobi, Nairobi, Kenya.

Reprints: Lorenzo Cerroni, MD, Research Unit of Dermatopathology, Department of Dermatology, Medical University of Graz, Auebnruggerplatz 8, 8036 Graz, Austria (e-mail:

Funding sources: none.

Conflict of interests: None.

© 2013 by Lippincott Williams & Wilkins.