INTRODUCTION
Lymphomatoid papulosis (LyP) and primary cutaneous anaplastic large cell lymphoma (ALCL) comprise a disease spectrum known as primary cutaneous CD30+ T-cell lymphoproliferative disorders (CD30+ LPD).1 CD30+ LPD is the second most common group of cutaneous T-cell lymphomas (CTCL) after mycosis fungoides (MF) and is regarded as an indolent lymphoproliferative disorder1 LyP typically manifests clinically as a recurrent eruption of papules and nodules with variable central ulceration, scale or crust that resolve spontaneously within several weeks and may result in hyperpigmentation, hypopigmentation, and scarring. LyP histology is usually characterized by wedge-shaped cellular infiltrate that contains atypical large CD30+ lymphocytes.1 LyP is uncommon in Black patients and have been described in a few case reports.2 Analysis of two separate collaborative cancer databases in the united states showed that CD30+ LPD is mainly diagnosed in Caucasian patients and only rarely in African American (AA)/Black patients. AA/Blacks comprised only 7%-8%3,4 and 10%5 of all CD30+ LPD patients included in these two large databases. A recent study of prognostic factors in CD30+ LPD patients with an emphasis on outcomes among ethnic groups, showed that AA patients have a significantly poorer overall survival than Caucasians.5 These studies did not differentiate LyP from other CD30+ LPD cases and did not elaborate on the symptoms and clinical features. Therefore, these findings and recommendations are difficult to interpret in routine clinical practice. We herein report on the clinical characteristics and disease course of LyP in a series of eight AA/Black patients from our institution and three previously published case reports.
REPORT
Eight AA/Black patients with a confirmed diagnosis of LyP
were identified in a retrospective search of the tumor registry
and pathology database at Memorial Sloan Kettering Cancer
(Table 1). Five males and three females presented to us between
the years 2000-2017 with a median age of 42 (range
of 28-75 years). Six patients were non-hispanic, one hispanic
and ethnicity was unknown in one patient. Five patients (63%)
were also diagnosed with MF either before, at the same time,
or after their LyP diagnosis. In half of the patients, lesions had
occurred 1-4 years before the patients were diagnosed and
presented to us. In one case, a diagnosis of LyP was made
three years earlier; and the rest of the patients had an onset of
less than one year prior to diagnosis. On physical examination
at presentation, all patients had multiple lesions; however,
one patient presented with one active lesion and few scars
from past lesions, and one patient had only hyperpigmented
macules and scars. In six (75%) of the patients, resolution of
