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under follow-up with a genetics and neurology team for suspected Angelman syndrome&#46; She had been using lamotrigine 50&#8239;mg&#47;day for two years and clonazepam 1&#8239;mg&#47;day&#46; She had a history of a lesion on the right temporal region for six months&#44; with progressive&#44; painless growth&#44; with no pruritus and no report of an insect bite at the site &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; On clinical examination&#44; she presented a circular plaque&#44; with sharp edges&#44; measuring 1&#46;2&#8239;cm in diameter&#44; with a smooth surface&#44; on the right temporal region&#46; The dermoscopic examination with contact polarized light&#44; without immersion&#44; showed a salmon-colored background&#44; discrete flaking&#44; with white dots interspersed with groups of rosettes of about 0&#46;2&#8239;mm&#44; oriented in the same direction &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; The biopsy of the lesion center was then performed with a 4-mm punch&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Histological examination showed an atypical lymphoid proliferation&#44; with intense lymphocytic infiltrate filling the papillary and superficial reticular dermis&#44; notably in its upper portion&#44; with a predominance of small lymphocytes with irregular nuclei and increased volume &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>A-B&#41;&#46; The immunohistochemical examination revealed a predominance of T lymphocytes reactive with CD3&#44; CD4&#44; and a lower expression of CD8&#59; B lymphocytes were detected in part of the infiltrate &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>C-F&#41; and there was no immunoexpression of CD30&#46; This pattern favors the diagnosis of T-cell pseudolymphoma&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">Rosettes can be found in dermoscopy with polarized light in melanocytic and non-melanocytic lesions&#44; but they are not pathognomonic of any dermatosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> They were described in 2009&#44; initially associated with actinic keratosis&#44; lichen planus-like keratosis&#44; and squamous cell carcinoma&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> In a series of 6&#44;108 <span class="elsevierStyleItalic">ex vivo</span> dermoscopies&#44; the presence of rosettes was verified in several conditions such as scars &#40;6&#46;4&#37;&#41;&#44; dermatofibroma &#40;6&#37;&#41;&#44; molluscum contagiosum &#40;5&#46;9&#37;&#41;&#44; squamous cell carcinoma &#40;4&#46;0&#37;&#41;&#44; basal cell carcinoma &#40;1&#46;7&#37;&#41;&#44; melanoma &#40;1&#46;4&#37;&#41; and nevi &#40;0&#46;7&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> There are also isolated reports of the presence of rosettes in a lesion of discoid lupus erythematosus and in papulopustular rosacea&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a> To the best of the authors&#8217; knowledge&#44; this is the first report of the presence of rosettes in T-cell pseudolymphoma&#44; but this finding may not be reproducible in other similar cases&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Unlike other crystalline structures&#44; the rosettes do not present angle-dependent enhancement&#59; therefore&#44; when rotating the dermoscope on its central axis&#44; the rosette remains static and does not follow the rotation of the instrument&#46; The rosettes are not all the same size&#59; the small ones &#40;0&#46;1&#8211;0&#46;2&#8239;mm&#41; appear to correspond to the dispersion of polarized light when in contact with follicular openings filled with opaque material or even with eccrine ducts at the level of the infundibulum&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> In turn&#44; larger rosettes &#40;0&#46;2&#8211;0&#46;5&#8239;mm&#41; would be the result of concentric fibrosis around the follicles&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> This diversity in size can be found in the same lesion&#44; and several white dots in between are common&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The white dots were described by Kossard in 1993 in contact dermoscopy with immersion without polarized light on the scalp of a patient with the hypothesis of pseudopelade or lichen planopilaris&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> In that study&#44; it was postulated that white dots were the result of a focal decrease in the epidermal melanin underlying fibrous tracts&#46; These findings were later related to several other conditions&#44; including cutaneous lymphocytoma&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10</span></a> The authors believe that rosettes and white dots are part of the spectrum of the same process&#44; as suggested in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#44; in which there is a mixture of well-formed rosettes that appear to gradually change into white dots &#40;yellow&#44; blue&#44; and green arrows&#44; respectively&#41;&#46; The authors also postulate that many of the white dots described without polarized light are actually rosettes&#44; which would be seen in a thorough analysis with polarized light dermoscopy&#46; However&#44; this clinical observation still lacks histological confirmation&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The dermoscopic findings of primary cutaneous B-cell lymphomas are not specific&#46; In an observational study by Geller et al&#46;&#44; 58 dermoscopic images of primary cutaneous B-cell lymphomas were evaluated&#59; salmon backgrounds were observed in 79&#46;3&#37; of the images and prominent vessels in 77&#46;2&#37;&#46; Mascolo et al&#46; observed white circular structures in 90&#37; of cases &#40;total n&#8239;&#61;&#8239;10&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Primary cutaneous T-cell lymphomas represent more than 75&#37; of cutaneous lymphomas&#46; Dermoscopic findings are better defined in cases of mycosis fungoides &#40;MF&#41;&#46; In studies by Bosseila et al&#46;&#44; small linear vessels were found in 93&#37; of cases of MF&#44; in addition to sharp vessels in 55&#37; and yellowish-orange areas&#46; Lallas et al&#46; also observed these findings&#44; in addition to vascular structures shaped as spermatozoa&#44; with high specificity for MF when compared with dermoscopy of chronic dermatitis lesions&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The studies on dermoscopy of pseudolymphomas are limited to case reports&#44; such as the description of linear vessels seen as whitish reticular lines in cutaneous lymphocytoma by Namiki et al&#46; Arborizing vessels and multiple yellow follicular and perifollicular dots were described by Fujimura et al&#46; in 2012 in cases of pseudolymphomatous folliculitis&#46; In the case of acral pseudolymphomatous angiokeratoma&#44; irregular linear vessels have been described&#44; in addition to white and pink areas with a rainbow pattern at the periphery &#40;Pinus et al&#46;&#41;&#46; In observational studies&#44; such as that by Navarrete-Dechent et al&#46;&#44; the dermoscopic findings of pseudolymphomas were analyzed together with those of primary cutaneous lymphomas&#44; suggesting that both share dermoscopic similarities&#44; such as an orange background &#40;71&#46;4&#37;&#41;&#44; follicular plugs &#40;85&#37;&#41;&#44; and linear vessels &#40;78&#46;5&#37;&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">T-cell pseudolymphomas have an indolent course and may resolve spontaneously after biopsy&#46; In the present case&#44; the authors opted for the use of high-potency topical corticosteroids on the lesion&#44; with a favorable evolution after three weeks &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Financial support</span><p id="par0055" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Authors&#8217; contributions</span><p id="par0060" class="elsevierStylePara elsevierViewall">Rodrigo Gomes Alves&#58; Drafting and editing of the manuscript&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Patricia Mayumi Ogawa&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; drafting and editing of the manuscript&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">M&#237;lvia Maria Sim&#245;es e Silva Enokihara&#58; Collection&#44; analysis&#44; and interpretation of data&#59; intellectual participation in propaedeutic and&#47;or therapeutic conduct of studied cases&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Sergio Henrique Hirata&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; collection&#44; analysis&#44; and interpretation of data&#59; effective participation in research orientation&#59; intellectual participation in propaedeutic and&#47;or therapeutic conduct of studied cases&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of interest</span><p id="par0080" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Rosettes are small white structures visible with polarized light dermoscopy&#44; whose exact morphological correlation is not yet defined&#46; These small shiny structures are found in several conditions such as scarring&#44; dermatofibroma&#44; molluscum contagiosum&#44; squamous cell carcinoma&#44; basal cell carcinoma&#44; melanoma&#44; melanocytic nevus&#44; discoid lupus erythematosus&#44; and papulopustular rosacea&#46; In this novel report&#44; the authors describe the presence of rosettes in a T-cell pseudolymphoma lesion&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Study conducted at the Department of Dermatology&#44; Universidade Federal de S&#227;o Paulo&#44; S&#227;o Paulo&#44; SP&#44; Brazil</p>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41;&#44; Skin biopsy showing an intense lymphocytic infiltrate filling the interstitial region of the papillary dermis and part of the superficial reticular dermis&#44; predominantly in the upper part of the dermis &#40;Hematoxylin &#38; eosin&#44; &#215;40&#41;&#46; &#40;B&#41;&#44; In the highlight&#44; there is a predominance of small lymphocytes with slight nuclear atypias &#40;slight increase in nuclear volume and slight irregularity in nuclear contours&#41; in addition to areas containing plasma cells and histiocytes &#40;Hematoxylin &#38; eosin&#44; &#215;400&#41;&#46; &#40;C&#41;&#44; &#40;CD3 &#8211; &#215;40&#41; Immunohistochemical exam showing a predominance of T lymphocytes CD3 positive&#46; &#40;D&#41;&#44; &#40;CD20 &#8211; &#215;40&#41; Immunohistochemical exam showing CD20 immunoexpression &#40;B lymphocytes&#41; in part of the infiltrate&#46; &#40;E&#41;&#44; &#40;CD4 &#8211; &#215;40&#41; A slight predominance of CD4 positive T lymphocytes can be observed in the infiltrate&#46; &#40;F&#41;&#44; &#40;CD8 &#8211; &#215;40&#41; CD8 showing less immunoexpression than CD4&#46;</p>"
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Case Report
Rosettes in T-cell pseudolymphoma: a new dermoscopic finding
Rodrigo Gomes Alves
Autor para correspondência
gomes.alves@unifesp.br

Corresponding author.
, Patricia Mayumi Ogawa, Mílvia Maria Simões e Silva Enokihara, Sergio Henrique Hirata
Department of Dermatology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41;&#44; Skin biopsy showing an intense lymphocytic infiltrate filling the interstitial region of the papillary dermis and part of the superficial reticular dermis&#44; predominantly in the upper part of the dermis &#40;Hematoxylin &#38; eosin&#44; &#215;40&#41;&#46; &#40;B&#41;&#44; In the highlight&#44; there is a predominance of small lymphocytes with slight nuclear atypias &#40;slight increase in nuclear volume and slight irregularity in nuclear contours&#41; in addition to areas containing plasma cells and histiocytes &#40;Hematoxylin &#38; eosin&#44; &#215;400&#41;&#46; &#40;C&#41;&#44; &#40;CD3 &#8211; &#215;40&#41; Immunohistochemical exam showing a predominance of T lymphocytes CD3 positive&#46; &#40;D&#41;&#44; &#40;CD20 &#8211; &#215;40&#41; Immunohistochemical exam showing CD20 immunoexpression &#40;B lymphocytes&#41; in part of the infiltrate&#46; &#40;E&#41;&#44; &#40;CD4 &#8211; &#215;40&#41; A slight predominance of CD4 positive T lymphocytes can be observed in the infiltrate&#46; &#40;F&#41;&#44; &#40;CD8 &#8211; &#215;40&#41; CD8 showing less immunoexpression than CD4&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Rosettes are small white structures grouped in the shape of a four-leaf clover&#44; visible only under polarized light dermoscopy&#46; While the literature presents some hypotheses&#44; their exact morphological correlation is not yet defined&#46; Initially&#44; the presence of rosettes corroborated the diagnosis of actinic keratosis and squamous cell carcinoma&#59; however&#44; these structures were later described in several other conditions&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> In this report&#44; the authors expanded the number of diseases associated with rosettes after finding them in T-cell pseudolymphoma&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">42-year-old female&#44; under follow-up with a genetics and neurology team for suspected Angelman syndrome&#46; She had been using lamotrigine 50&#8239;mg&#47;day for two years and clonazepam 1&#8239;mg&#47;day&#46; She had a history of a lesion on the right temporal region for six months&#44; with progressive&#44; painless growth&#44; with no pruritus and no report of an insect bite at the site &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; On clinical examination&#44; she presented a circular plaque&#44; with sharp edges&#44; measuring 1&#46;2&#8239;cm in diameter&#44; with a smooth surface&#44; on the right temporal region&#46; The dermoscopic examination with contact polarized light&#44; without immersion&#44; showed a salmon-colored background&#44; discrete flaking&#44; with white dots interspersed with groups of rosettes of about 0&#46;2&#8239;mm&#44; oriented in the same direction &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; The biopsy of the lesion center was then performed with a 4-mm punch&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Histological examination showed an atypical lymphoid proliferation&#44; with intense lymphocytic infiltrate filling the papillary and superficial reticular dermis&#44; notably in its upper portion&#44; with a predominance of small lymphocytes with irregular nuclei and increased volume &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>A-B&#41;&#46; The immunohistochemical examination revealed a predominance of T lymphocytes reactive with CD3&#44; CD4&#44; and a lower expression of CD8&#59; B lymphocytes were detected in part of the infiltrate &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>C-F&#41; and there was no immunoexpression of CD30&#46; This pattern favors the diagnosis of T-cell pseudolymphoma&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">Rosettes can be found in dermoscopy with polarized light in melanocytic and non-melanocytic lesions&#44; but they are not pathognomonic of any dermatosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> They were described in 2009&#44; initially associated with actinic keratosis&#44; lichen planus-like keratosis&#44; and squamous cell carcinoma&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> In a series of 6&#44;108 <span class="elsevierStyleItalic">ex vivo</span> dermoscopies&#44; the presence of rosettes was verified in several conditions such as scars &#40;6&#46;4&#37;&#41;&#44; dermatofibroma &#40;6&#37;&#41;&#44; molluscum contagiosum &#40;5&#46;9&#37;&#41;&#44; squamous cell carcinoma &#40;4&#46;0&#37;&#41;&#44; basal cell carcinoma &#40;1&#46;7&#37;&#41;&#44; melanoma &#40;1&#46;4&#37;&#41; and nevi &#40;0&#46;7&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> There are also isolated reports of the presence of rosettes in a lesion of discoid lupus erythematosus and in papulopustular rosacea&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a> To the best of the authors&#8217; knowledge&#44; this is the first report of the presence of rosettes in T-cell pseudolymphoma&#44; but this finding may not be reproducible in other similar cases&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Unlike other crystalline structures&#44; the rosettes do not present angle-dependent enhancement&#59; therefore&#44; when rotating the dermoscope on its central axis&#44; the rosette remains static and does not follow the rotation of the instrument&#46; The rosettes are not all the same size&#59; the small ones &#40;0&#46;1&#8211;0&#46;2&#8239;mm&#41; appear to correspond to the dispersion of polarized light when in contact with follicular openings filled with opaque material or even with eccrine ducts at the level of the infundibulum&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> In turn&#44; larger rosettes &#40;0&#46;2&#8211;0&#46;5&#8239;mm&#41; would be the result of concentric fibrosis around the follicles&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> This diversity in size can be found in the same lesion&#44; and several white dots in between are common&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The white dots were described by Kossard in 1993 in contact dermoscopy with immersion without polarized light on the scalp of a patient with the hypothesis of pseudopelade or lichen planopilaris&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> In that study&#44; it was postulated that white dots were the result of a focal decrease in the epidermal melanin underlying fibrous tracts&#46; These findings were later related to several other conditions&#44; including cutaneous lymphocytoma&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10</span></a> The authors believe that rosettes and white dots are part of the spectrum of the same process&#44; as suggested in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#44; in which there is a mixture of well-formed rosettes that appear to gradually change into white dots &#40;yellow&#44; blue&#44; and green arrows&#44; respectively&#41;&#46; The authors also postulate that many of the white dots described without polarized light are actually rosettes&#44; which would be seen in a thorough analysis with polarized light dermoscopy&#46; However&#44; this clinical observation still lacks histological confirmation&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The dermoscopic findings of primary cutaneous B-cell lymphomas are not specific&#46; In an observational study by Geller et al&#46;&#44; 58 dermoscopic images of primary cutaneous B-cell lymphomas were evaluated&#59; salmon backgrounds were observed in 79&#46;3&#37; of the images and prominent vessels in 77&#46;2&#37;&#46; Mascolo et al&#46; observed white circular structures in 90&#37; of cases &#40;total n&#8239;&#61;&#8239;10&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Primary cutaneous T-cell lymphomas represent more than 75&#37; of cutaneous lymphomas&#46; Dermoscopic findings are better defined in cases of mycosis fungoides &#40;MF&#41;&#46; In studies by Bosseila et al&#46;&#44; small linear vessels were found in 93&#37; of cases of MF&#44; in addition to sharp vessels in 55&#37; and yellowish-orange areas&#46; Lallas et al&#46; also observed these findings&#44; in addition to vascular structures shaped as spermatozoa&#44; with high specificity for MF when compared with dermoscopy of chronic dermatitis lesions&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The studies on dermoscopy of pseudolymphomas are limited to case reports&#44; such as the description of linear vessels seen as whitish reticular lines in cutaneous lymphocytoma by Namiki et al&#46; Arborizing vessels and multiple yellow follicular and perifollicular dots were described by Fujimura et al&#46; in 2012 in cases of pseudolymphomatous folliculitis&#46; In the case of acral pseudolymphomatous angiokeratoma&#44; irregular linear vessels have been described&#44; in addition to white and pink areas with a rainbow pattern at the periphery &#40;Pinus et al&#46;&#41;&#46; In observational studies&#44; such as that by Navarrete-Dechent et al&#46;&#44; the dermoscopic findings of pseudolymphomas were analyzed together with those of primary cutaneous lymphomas&#44; suggesting that both share dermoscopic similarities&#44; such as an orange background &#40;71&#46;4&#37;&#41;&#44; follicular plugs &#40;85&#37;&#41;&#44; and linear vessels &#40;78&#46;5&#37;&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">T-cell pseudolymphomas have an indolent course and may resolve spontaneously after biopsy&#46; In the present case&#44; the authors opted for the use of high-potency topical corticosteroids on the lesion&#44; with a favorable evolution after three weeks &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Financial support</span><p id="par0055" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Authors&#8217; contributions</span><p id="par0060" class="elsevierStylePara elsevierViewall">Rodrigo Gomes Alves&#58; Drafting and editing of the manuscript&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Patricia Mayumi Ogawa&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; drafting and editing of the manuscript&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">M&#237;lvia Maria Sim&#245;es e Silva Enokihara&#58; Collection&#44; analysis&#44; and interpretation of data&#59; intellectual participation in propaedeutic and&#47;or therapeutic conduct of studied cases&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Sergio Henrique Hirata&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; collection&#44; analysis&#44; and interpretation of data&#59; effective participation in research orientation&#59; intellectual participation in propaedeutic and&#47;or therapeutic conduct of studied cases&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of interest</span><p id="par0080" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Rosettes are small white structures visible with polarized light dermoscopy&#44; whose exact morphological correlation is not yet defined&#46; These small shiny structures are found in several conditions such as scarring&#44; dermatofibroma&#44; molluscum contagiosum&#44; squamous cell carcinoma&#44; basal cell carcinoma&#44; melanoma&#44; melanocytic nevus&#44; discoid lupus erythematosus&#44; and papulopustular rosacea&#46; In this novel report&#44; the authors describe the presence of rosettes in a T-cell pseudolymphoma lesion&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Study conducted at the Department of Dermatology&#44; Universidade Federal de S&#227;o Paulo&#44; S&#227;o Paulo&#44; SP&#44; Brazil</p>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41;&#44; Skin biopsy showing an intense lymphocytic infiltrate filling the interstitial region of the papillary dermis and part of the superficial reticular dermis&#44; predominantly in the upper part of the dermis &#40;Hematoxylin &#38; eosin&#44; &#215;40&#41;&#46; &#40;B&#41;&#44; In the highlight&#44; there is a predominance of small lymphocytes with slight nuclear atypias &#40;slight increase in nuclear volume and slight irregularity in nuclear contours&#41; in addition to areas containing plasma cells and histiocytes &#40;Hematoxylin &#38; eosin&#44; &#215;400&#41;&#46; &#40;C&#41;&#44; &#40;CD3 &#8211; &#215;40&#41; Immunohistochemical exam showing a predominance of T lymphocytes CD3 positive&#46; &#40;D&#41;&#44; &#40;CD20 &#8211; &#215;40&#41; Immunohistochemical exam showing CD20 immunoexpression &#40;B lymphocytes&#41; in part of the infiltrate&#46; &#40;E&#41;&#44; &#40;CD4 &#8211; &#215;40&#41; A slight predominance of CD4 positive T lymphocytes can be observed in the infiltrate&#46; &#40;F&#41;&#44; &#40;CD8 &#8211; &#215;40&#41; CD8 showing less immunoexpression than CD4&#46;</p>"
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