NORD gratefully acknowledges Anasheh Navasarkian, NORD Editorial Intern from the Keck Graduate Institute and Larisa J. Geskin, MD, FAAD, Associate Professor in Dermatology and Medicine (Division of Hematology-Oncology), Director, Comprehensive Cutaneous Oncology Center, Department of Dermatology, Columbia University and CUMC, for assistance in the preparation of this report.
Lymphocytic infiltrate of Jessner is a rare skin condition that may be characterized by non-cancerous (benign) buildup of white blood cells, which present as lesions or lumps on the skin. These lesions may be seen on areas including the face, neck, upper extremities, shoulders, and upper back (skin most exposed to sunlight). They may be described as small, non-scaly in nature, and pink/red in color. Although the lesions are typically not painful, patients with lymphocytic infiltrate of Jessner may experience itchiness and redness. Presentation can vary, for example, the lesions may remain unchanged for several years and resolve. Other patients may go through worsening of symptoms for years.
Lymphocytic infiltrate of Jessner has been thought to fall in the same spectrum as the autoimmune disease known as lupus tumidus or discoid lupus erythematosus. However, other scientists believe that lymphocytic infiltrate of Jessner should be designated its own category.
Patients living with lymphocytic infiltrate of Jessner may experience symptoms including itchiness (pruritus), redness of the skin (erythema), and pimple-like eruptions (papules), most commonly on areas exposed to sunlight. These pimple-like lesions may last up to several months. As they extend from the perimeter, these lesions form well-defined, smooth, red patches (plaques) whose diameter may go as far as up to one inch.
Occasionally, clear centers will form on the plaques. The skin surrounding the lesions may be reddened or itching. Those affected may also experience a burning sensation surrounding the skin lesions. An additional symptom that people with Jessner disease frequently report is sensitivity of the skin to sunlight exposure cutaneous photosensitivity.
The course of lymphocytic Infiltrate of Jessner varies from person to person. It is important to note that the symptoms typically disappear after several years but it is also possible that they may reappear later. The course or progression of the disease may alternate between periods of worsening and relieving of symptoms. These periods may last up to months or even years in some individuals.
Lymphocytic Infiltrate of Jessner is a rare inflammatory disease with an unknown cause. What is known however is that this condition involves the inappropriate accumulation of T helper cells (subtype of white blood cells) in the skin. Some clinical scientists argue that this condition is possibly a subtype of the autoimmune condition known as lupus erythematosus, while others believe that it may have its own class.
Jessner disease may have a genetic/hereditary component. In addition, affected individuals may also have a prior history of photosensitivity.
While its prevalence in the United States or Europe is not clearly understood as of yet, some scientists believe that lymphocytic Infiltrate of Jessner occurs predominantly in males. In addition, its onset usually occurs between the ages of thirty and fifty and rarely affects children.
First, a thorough medical history and physical examination should be completed to assess for all potential risk factors including genetics and photosensitivity. In addition, a skin biopsy from a newly formed lesion should be tested in order to rule out other similar conditions including discoid lupus erythematosus (DLE) and polymorphous light eruption (PLE).
Additional labs may also be beneficial in confirming the diagnosis and ruling out other conditions, which may include lymphocytoma cutis (blood cell cancer of the skin). Such assessments include a complete blood count (CBC), presence of antibodies using the antinuclear antibody panel (ANA test), and presence of inflammation or autoimmune disease with the erythrocyte sedimentation rate (ESR).
Since lymphocytic Infiltrate of Jessner may sometimes resolve on its own, initial recommendation usually includes watchful waiting. In this case, treatment may not be necessary.
Others who may need to seek treatment might be advised to use cosmetics to improve appearance, protect from sunlight, removal of the lesions via surgery, radiotherapy, steroids including topical medium-potency formulations, freezing of the lesions (cryotherapy), the use of select oral medications, or appropriate chemotherapy drugs (cyclophosphamide, methotrexate).
It is important to note that the use of steroids, whether they be topical or systemic, must be monitored very closely. In addition, routine follow-up visits to the dermatologist are essential to monitor overall progress and treatment. Those seeking treatment must also remember to protect from sunlight to prevent progression of existing lesions or formation of new lesions.
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Champion RH, Burton JL, Ebling FJG, eds. Textbook of Dermatology. 5th ed. Blackwell Scientific Publications. London, UK; 1992:2103-04.
Geskin LJ. Jessner’s lymphocytic infiltrate. UpToDate. last updated: Mar 12, 2018. https://www.uptodate.com/contents/jessners-lymphocytic-infiltrate Accessed Nov 20, 2019.
Torres KM. Jessner Lymphocytic Infiltration of the Skin. Medscape. Last Updated: Dec 13, 2017. www.emedicine.com/derm/topic200.htm Accessed Nov 20, 2019.
Lymphocytic infiltrate of Jessner. Genetic and Rare Diseases Information Center (GARD). Last updated: 10/13/2016. https://rarediseases.info.nih.gov/diseases/6940/lymphocytic-infiltrate-of-jessner . Accessed Nov 20, 2019.
Jessner Lymphocytic Infiltrate – American Osteopathic College of Dermatology (AOCD). http://www.aocd.org/page/JessnerLymphocytic . Accessed Nov 20, 2019.
Orphanet: Jessner lymphocytic infiltration of the skin. Last update: April 2009. http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Lng=GB&Expert=33314 Accessed Nov 20, 2019.
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