Jessner benign lymphocytic infiltrate in Adult
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.
L98.6 – Other infiltrative disorders of the skin and subcutaneous tissue
19719003 – Benign lymphocytic infiltration of Jessner
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.