Background: Lymphomatoid papulosis (LyP) is a self-healing CD30+ cutaneous lymphoproliferative disorder (CLPD) with paradoxical histology of a malignant lymphoma. Case reports and small patient series suggest an association of LyP with atopy. However, the prevalence of atopy depends on patient recall which is not always reliable. More objective criteria of atopy include skin reactivity to allergens and IgE reactivity to allergens. This study was undertaken to determine if atopy is prevalent in LyP patients using IgE specific antibodies to aeroallergens, and if Staphylococcal aureus enterotoxins might be a pathogenic factors for LyP as proposed for other skin disorders. Methods: Thirty-one samples of patients with CD30+ CLPD were tested for total serum IgE (IgE-t) and 10 IgE-specific airborne allergens with the Phadiatop multiallergen test, which if positive, is regarded as evidence of atopy. Sera was tested for IgE reactive against three Staphylococcal enterotoxins with superantigenic properties (SSAg-IgE). Control sera were obtained from adult subjects evaluated for rhino-sinusitis and a negative Phadiatop test. Patient history of atopy was obtained by retrospective chart review. Findings: Nearly 50% of LyP patients had a positive Phadiatop test and IgE-t was increased compared to non-atopic controls. Seven of 28 (25%) LyP patients had at least one SSAg-IgE at the concentration used to define serologic atopy (0.35 kUa/L) compared to 3/52 (6%) controls (P= 0.028). TSST1-IgE was detected in 7 (23%) specimens of CD30CLPD, often together with SEB-IgE; SEA-IgE was not detected. TSST1-IgE exceeded the 0.35 kUa/L threshold in 3 (6%) controls. Conclusions: LyP patients have an increased prevalence of atopy as determined by the Phadiatop test and increased prevalence of SSAg-IgE compared to controls. Prevalence of serologic atopy exceeded that reported by patient medical history. The results support the hypothesis that an atopic diathesis and possibly SSAg contribute to the pathogenesis of LyP.

中文翻译：

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特应性和葡萄球菌超抗原与淋巴瘤性丘疹病（CD30 +皮肤性皮肤增生性疾病复发）的发病机理相关的证据

背景：淋巴瘤样丘疹病（LyP）是一种自愈性CD30 +皮肤淋巴增生性疾病（CLPD），具有与恶性淋巴瘤相悖的组织学特征。病例报告和少量患者系列提示LyP与特应性疾病有关。然而，特应性的患病率取决于患者的记忆力，这并不总是可靠的。特应性的更客观标准包括皮肤对过敏原的反应性和IgE对过敏原的反应性。这项研究旨在确定使用IgE特异性抗气敏原性抗体的LyP患者中特应性是否普遍，以及是否如其他皮肤病所建议的那样，葡萄球菌金黄色葡萄球菌肠毒素可能是LyP的致病因素。方法：用Phadiatop多变应原测试对31例CD30 + CLPD患者的样本进行了总血清IgE（IgE-t）和10种IgE特异性空气传播变应原的测试，如果为阳性，则视为特应性的证据。测试了血清对三种具有超级抗原特性的葡萄球菌肠毒素（SSAg-IgE）有反应性的IgE。从评估鼻-鼻窦炎和阴性Phadiatop测试的成年受试者获得对照血清。通过回顾性图表回顾获得特应性病史。结果：与非异位对照相比，近50％的LyP患者Phadiatop试验呈阳性，并且IgE-t升高。在28名（25％）LyP患者中，有7名至少有一种SSAg-IgE的浓度可用于定义血清学特应性（0.35 kUa / L），而对照组则为3/52（6％）（P = 0.028）。在CD30CLPD的7个样本中检测到TSST1-IgE，通常与SEB-IgE一起检测到；未检测到SEA-IgE。在3个（6％）对照中，TSST1-IgE超过了0.35 kUa / L阈值。结论：与对照组相比，通过Phadiatop测试确定，LyP患者的特应性患病率增加，SSAg-IgE的患病率增加。血清特应性疾病的患病率超过了患者病史的报告。结果支持以下假设：特应性素质和可能的SSAg有助于LyP的发病机理。