Summary about Disease
Jessner-Kanof lymphocytic infiltration of the skin (Jessner's lymphocytic infiltration or JLI) is a benign, chronic skin condition characterized by single or multiple, raised, reddish-purple papules or plaques that primarily occur on the face, neck, and upper back. It is thought to be a reactive process or a form of cutaneous lymphoid hyperplasia, but the exact cause remains unknown. It tends to wax and wane spontaneously.
Symptoms
Raised, smooth, firm papules or plaques.
Color ranges from pink to red to violaceous (purple-ish).
Lesions typically occur on the face (especially the cheeks), neck, and upper back, but can appear elsewhere.
Lesions are usually asymptomatic (no itching or pain), but some individuals may experience mild itching.
Individual lesions may resolve spontaneously, only to have new lesions appear.
Causes
The exact cause of Jessner's lymphocytic infiltration is unknown. It is considered a benign lymphoproliferative disorder. Some theories suggest it may be a reaction to:
Sun exposure (photosensitivity)
Insect bites
Viral infections
Unknown antigens
Medicine Used
Treatment aims to control symptoms and improve cosmetic appearance. Common treatments include:
Topical Corticosteroids: To reduce inflammation.
Topical Calcineurin Inhibitors (Tacrolimus, Pimecrolimus): Alternative to corticosteroids, especially for long-term use on the face.
Antimalarials (Hydroxychloroquine): Often effective in suppressing the condition.
Phototherapy (PUVA, UVB): Light therapy to reduce inflammation.
Systemic Corticosteroids: Rarely used due to side effects, but may be considered for severe cases.
Other Systemic Agents: In resistant cases, medications like methotrexate or dapsone may be considered.
Is Communicable
No, Jessner's lymphocytic infiltration is not contagious or communicable. It is not caused by an infectious agent and cannot be spread to others through contact.
Precautions
Sun Protection: Use sunscreen with a high SPF (30 or higher) daily, even on cloudy days. Wear protective clothing and hats when outdoors.
Avoid Sun Exposure: Limit time spent in direct sunlight, especially during peak hours.
Follow Treatment Plan: Adhere to the prescribed medication regimen and follow-up appointments with your dermatologist.
Avoid Triggers (If Known): If you identify any specific triggers (e.g., certain insect bites), try to avoid them.
How long does an outbreak last?
The duration of an outbreak is variable. Individual lesions may resolve spontaneously within weeks to months, but new lesions can appear intermittently. The condition can be chronic, with periods of remission and exacerbation lasting for months or years.
How is it diagnosed?
Diagnosis typically involves:
Clinical Examination: The doctor will examine the appearance and distribution of the lesions.
Skin Biopsy: A small sample of skin is removed and examined under a microscope to confirm the diagnosis and rule out other conditions. The biopsy will show a dense infiltrate of lymphocytes in the dermis.
Ruling Out Other Conditions: The doctor will rule out other conditions that can mimic Jessner's lymphocytic infiltration, such as lupus erythematosus, sarcoidosis, and lymphoma.
Timeline of Symptoms
Jessner's lymphocytic infiltration typically follows a chronic, relapsing course. A possible timeline:
Initial Appearance: One or more small, raised papules or plaques appear on the face, neck, or upper back.
Progression: Lesions may slowly enlarge or new lesions may develop over time.
Fluctuation: The lesions may wax and wane spontaneously, with periods of improvement and worsening.
Persistence: Without treatment, the lesions may persist for months or years.
Response to Treatment: With appropriate treatment, the lesions may fade or disappear, but recurrence is common.
Important Considerations
Differential Diagnosis: It's crucial to differentiate JLI from other skin conditions with similar appearances, especially lupus erythematosus. A skin biopsy is key.
Cosmetic Impact: The lesions can be cosmetically bothersome, particularly when located on the face. Treatment can improve appearance and quality of life.
Association with Other Conditions: While generally considered a benign condition, there have been rare reports of association with systemic diseases. However, the link remains unclear and controversial.
Long-Term Management: Jessner's lymphocytic infiltration often requires long-term management to control symptoms and prevent recurrences. Regular follow-up with a dermatologist is important.