Dermatopathic lymphadenopathy is a distinctive reaction pattern in lymph nodes characterized by paracortical hyperplasia composed of interdigitating dendritic cells (IDC), Langerhans cells (LC), macrophages containing melanin pigment, and small T-cells. Dermatopathic lymphadenopathy is believed to represent an exaggerated response to increased antigenic stimulation in the skin.
Dermatopathic lymphadenopathy usually presents as enlarged superficial lymph nodes, most often involving the axillary or inguinal regions. Most patients have a chronic dermatopathy that precedes the development of dermatopathic lymphadenopathy by months or years. Skin conditions that have been associated with dermatopathic lymphadenopathy include pemphigus, psoriasis, eczema, neurodermatitis, atrophia senilis, and toxic shock syndrome. Importantly, up to 75 % of patients with mycosis fungoides (MF) or Sezary syndrome (SS) have lymphadenopathy, which may be due to dermatopathic lymphadenopathy alone or a combination of dermatopathic changes with nodal involvement by MF/SS. Some patients with mild dermatopathic lymphadenopathy do not have skin disease or other discernible etiologies to explain the lymph node findings.
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