Jessner benign lymphocytic infiltrate in Child
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Synopsis

Jessner benign lymphocytic infiltrate, or Jessner lymphocytic infiltration of the skin (JLIS), is a dermal infiltrate of lymphocytes that was characterized by Jessner and Kanoff in 1953. Clinically, there are one or more asymptomatic erythematous papules or plaques, often with an annular configuration on the face, neck, and sometimes the upper trunk. JLIS typically occurs in adults in their 30s and 40s and is quite rare in children. The disease waxes and wanes in severity over time. Some patients worsen in winter, and sunlight may exacerbate the disease in others. Individual lesions tend to resolve over weeks to months, and the cutaneous manifestations of JLIS tend to resolve over years. There is no systemic involvement.
The etiology and pathophysiology of JLIS are not well understood. Rare associations, such as medication intake (angiotensin-converting enzyme inhibitors and glatiramer acetate) and infections (Borrelia burgdorferi in Europe) have been noted.
Currently, the status of JLIS as a separate entity is questioned by many authors. Some cases have been thought to represent tumid lupus, others a form of polymorphous light eruption, and others classified as a pseudolymphoma. These diagnoses need to be entertained and ruled out first.
The etiology and pathophysiology of JLIS are not well understood. Rare associations, such as medication intake (angiotensin-converting enzyme inhibitors and glatiramer acetate) and infections (Borrelia burgdorferi in Europe) have been noted.
Currently, the status of JLIS as a separate entity is questioned by many authors. Some cases have been thought to represent tumid lupus, others a form of polymorphous light eruption, and others classified as a pseudolymphoma. These diagnoses need to be entertained and ruled out first.
Codes
ICD10CM:
L98.6 – Other infiltrative disorders of the skin and subcutaneous tissue
SNOMEDCT:
19719003 – Benign lymphocytic infiltration of Jessner
L98.6 – Other infiltrative disorders of the skin and subcutaneous tissue
SNOMEDCT:
19719003 – Benign lymphocytic infiltration of Jessner
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Differential Diagnosis & Pitfalls
- Tumid lupus – Abundant dermal mucin on histopathology but may be difficult to distinguish from JLIS. There is a strong female predominance. Clinically, it typically presents as an erythematous plaque on the face (especially the nose). Annular configuration or involvement of the back, both features common in JLIS, are rare. Lupus band test is more likely to be positive.
- Polymorphous light eruption – Favors extensor arms and displays dermal edema on histopathology. JLIS is thought by some to represent a plaque form of polymorphous light eruption.
- Cutaneous lymphoid hyperplasia – Dense nodular lymphocytic infiltrate on histopathology.
- Subacute cutaneous lupus erythematosus – Usually has scaly plaques.
- Discoid lupus erythematosus
- Erythema migrans (Lyme disease)
- Granuloma faciale
- Leukemia cutis – Monoclonal population of lymphocytes.
- Cutaneous lymphoma – Monoclonal population of lymphocytes.
- Reticular erythematous mucinosis – Clinically, it has a reticular appearance and has a predilection for the central chest.
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Last Reviewed:09/09/2018
Last Updated:09/09/2018
Last Updated:09/09/2018