Abstract
Primary cutaneous CD4+ small/medium pleomorphic T-cell lymphoproliferative disorder (PCSMP-TLPD) is a rare provisional entity with uncertain malignant potential, with most cases presenting an indolent course and favorable prognosis. Clinically, PCSMP-TLPD presents as a solitary and asymptomatic lesion, usually in the head and neck region and trunk. An 86-year-old man was referred with a complaint of crusted lesion on the left side of the face for 1 year, with symptomatology in the last days. After incisional biopsy, microscopy showed a dermal infiltrate in a band‐like distribution of small/medium‐sized pleomorphic lymphocytes. Moreover, focal epidermotropism and folliculotropic patterns were observed. Immunohistochemistry showed positivity for CD3 and CD4 in the neoplastic cells. Disease staging showed local involvement. After 3 years of follow-up, the patient is healthy. PCSMP-TLPD presents an indolent course, such as shown in the current case, so its correct diagnosis is important due to the prognostic implications.
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