Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder nodule successfully treated with laser Co2 ablation: a case report and literature review

Corrado Zengarini; Alba Guglielmo; Martina Mussi; Andrea Filippini; Sabina Vaccari; Bianca Maria Piraccini; Alessandro Pileri

doi:10.4081/dr.2024.9884

Authors

Corrado Zengarini Department of Medical Sciences and Surgery, University of Bologna; Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy. https://orcid.org/0000-0002-3323-9216
Alba Guglielmo
albaguglielmo@gmail.com
Department of Medical Sciences and Surgery, University of Bologna; Institute of Dermatology, “Santa Maria della Misericordia” University Hospital, Udine, Italy. https://orcid.org/0000-0003-2827-409X
Martina Mussi Department of Medical Sciences and Surgery, University of Bologna; Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy. https://orcid.org/0000-0003-0955-6112
Andrea Filippini Department of Medical Sciences and Surgery, University of Bologna; Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy. https://orcid.org/0000-0003-3257-2209
Sabina Vaccari Department of Medical Sciences and Surgery, University of Bologna; Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
Bianca Maria Piraccini Department of Medical Sciences and Surgery, University of Bologna; Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy. https://orcid.org/0000-0001-6537-9689
Alessandro Pileri Department of Medical Sciences and Surgery, University of Bologna; Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy. https://orcid.org/0000-0002-1025-7171

This case report describes an 83-year-old patient with a history of non-melanoma skin cancer who presented with a violaceous, painless nodule on the neck. Dermoscopic examination and subsequent biopsy revealed a Small/Medium CD4+ T-cell lymphoproliferative disorder (SMPLPD) of the skin. Although excision was initially recommended, the patient opted for treatment with CO2 laser ablation. The procedure had some minor complications but resulted in successful healing. SMPLPDs are a rare skin condition with limited treatment data, and this case suggests that CO2 laser ablation with minimal margins could be a viable alternative for selected patients, reducing bleeding and promoting second-intention healing for small nodules. However, more extensive follow-up data for SMPLPD cases are needed to understand long-term outcomes better.

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Zengarini, C., Guglielmo, A., Mussi, M., Filippini, A., Vaccari, S., Piraccini, B. M., & Pileri, A. (2024). Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder nodule successfully treated with laser Co2 ablation: a case report and literature review. Dermatology Reports, 16(4). https://doi.org/10.4081/dr.2024.9884