Lymphocytoma cutis induced by gold pierced earrings

El linfoma cutáneo primario T CD8⁺ tipo acral ha sido incluido como entidad provisional dentro de la nueva clasificación revisada de las neoplasias linfoides de la Organización Mundial de la Salud en 2016¹. Inicialmente fue descrito como proliferación linfoide CD8⁺ indolente de la oreja², y se han publicado en la literatura un total de 29 casos de dicha neoplasia. Ninguno de ellos se ha relacionado con reacciones de hipersensibilidad retardada de contacto. Presentamos un caso de linfoma cutáneo primario T CD8⁺ tipo acral auricular bilobular en clara relación etiológica con el uso prolongado de unos pendientes de oro confirmada con pruebas epicutáneas, estudio histológico, inmunohistoquímico y molecular. Las lesiones cutáneas bilobulares fueron inducidas de nuevo con un test de uso e idénticos resultados a los iniciales y misma clonalidad, lo cual terminó de confirmar tanto el diagnóstico del linfoma como su inducción por el estímulo antigénico del oro.

Primary cutaneous CD8⁺ T-cell lymphoma has been included as a provisional entity within the new revised classification of lymphoid neoplasms of the World Health Organization in 2016¹. It was initially described as indolent CD8⁺ lymphoid proliferation of the ear² and a total of 29 cases of such neoplasm have been published in the literature so far. None of them have been linked to delayed contact hypersensitivity reactions. We present a case of acral type primary cutaneous lymphoma T CD8⁺ involving both earlobes clearly related with the prolonged use of gold earrings, confirmed with epicutaneous tests, histopathology, immunohistochemical and molecular studies. Auricular skin lesions were induced again with a provocation test with identical histopathologycal and the same clonality, confirming both the diagnosis of lymphoma and its induction by the antigenic stimulus of gold.

Although earrings have been worn since time immemorial, most clinicians will have noticed more and more patients over the past 30 years who have been seen to have single or multiple piercing almost anywhere into the skin. This article will try to trace the history of body piercing, its comparatively recent popularity, where on the body piercing occurs, and the requirement for guidelines and legislation to try to ensure that the risks inherent in body piercing are lessened.