engleski

The possible role of radiation in the etiopathogenesis of lymphomatoid papulosis

Lymphomatoid papulosis is a very rare primary skin lymphoma characterized by papular, papulonecrotic and/or nodular lesions in different stages of development, predominantly located on the trunk and extremities. We report on a 30-year-old man, industrial radiology engineer. The appearance of cutaneous lesions was observed in autumn 2003. The lesions occurred after his continuous two-year work in an area where he had been exposed to various types of radiation (x-ray, ultraviolet, electromagnetic, and nuclear). He had performed regular dosimetric monitoring, with monthly dosimeter con&not ; ; trol at Croatian Institute of Radiation Protection. While working in the ionizing radiation area, he strictly followed all occupational safety regulations. Rare erythematous papules, papulonecrotic lesions, nodules and disseminated atrophic scars was presented on his face, neck, trunk and extremities. Clinical, histology and immunohistochemistry findings indicated the diagnosis of lymphomatoid papulosis. His physical status was normal, and so was standard blood and urine biochemistry. Plain X-ray of thoracic organs, abdomi&not ; ; nal ultrasound and cytology of bone marrow biopsy showed normal findings. Polimerase chain reaction of T cell receptor and heavy chains of immunoglobulins excluded mono&not ; ; clonality. Different therapeutic possibilities have been purposed in the literature. Since our patient has been exposed to ultraviolet radiation professionally, phototherapy and photochemoterapy were not our therapy of choice. The patient was treated with “ 7, 5 mg” methotrexate per week, for the total of 6 weeks. The lesions that were noticed at the beginning of the hospitalization showed complete regression. There were no signs of relapses during the 6 months follow up.

Lymphomatoid papulosis; skin lymphoma; radiation

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