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Dermatology Online Journal

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Cutaneous B cell pseudolymphoma treated with rituximab and methotrexate

  • Author(s): Besch-Stokes, Jake G;
  • Patel, Meera H;
  • Brumfiel, Caitlin M;
  • Costello, Collin M;
  • Rule, William;
  • Rosenthal, Allison;
  • Pittelkow, Mark R;
  • DiCaudo, David J;
  • Mangold, Aaron R
  • et al.

Cutaneous B cell pseudolymphoma (CBPL), or cutaneous lymphoid hyperplasia, is the most common pseudolymphoma. It typically responds well to local treatment and follows a benign course. Herein, we describe the unique case of a patient with CBPL that was refractory to a variety of treatments, with subsequent response to rituximab followed by methotrexate. This case explores the complex interplay of T and B lymphocytes, and the potential role of perifollicular T cells in treatment resistant CBPL. Further, it describes the additive therapeutic effect of rituximab and methotrexate to target both B cell and T cell populations in CBPL, a strategy already employed in a number of other conditions.

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