Cutaneous Lymphadenoma: A Case of Recurrence after Shave Exc
Cutaneous lymphadenoma (CL) is a rare skin tumor supposedly derived from the pilosebaceous unit. Since its description in 1987, fewer than 60 cases have been documented.

An otherwise healthy 21-year-old woman presented for evaluation of a skin lesion on her forehead which had first appeared about seven years earlier. It had gradually grown to a 3–4?mm papule over four years when it was removed via shave excision. Approximately six months before visiting our department the lesion reemerged with a considerably faster growth rate that resulted in a 5–6?mm papule. Physical examination revealed a smooth skin-colored superficial papule with a central crust between the eyebrows. An excisional biopsy with a 3?mm margin was performed for histopathologic evaluation.

The histopathological examination revealed a dermal nodule of interconnected islands, sheets, and trabeculae of epithelial cells within a sclerotic stroma. The epithelial cells had eosinophilic to clear cytoplasm and mild pleomorphic vesicular nuclei. A peripheral rim of palisading basophilic cells surrounded the epithelial islands. A sclerotic stroma with dense infiltration of inflammatory cells contained the islands. The infiltration prominently consisted of lymphocytes and few plasma cells that permeated the epithelial nests. These histopathological findings were in favor of CL.

Simple excision is currently the treatment of choice in CL. Since recurrence and metastasis have not been reported to date, the reemergence of the lesion, in this case, might be attributed to the insufficient margin of shave excision. Additionally, if the tumor margins are not clinically well defined, Mohs surgery is particularly useful in such cases to ensure complete removal of the lesion. Mohs surgery might also be beneficial in cases that are located in anatomically sensitive areas where tissue preservation is critical.