Refractory cutaneous pseudolymphoma treated with tapinarof

Cutaneous pseudolymphoma (CPL) is a reactive polyclonal T- or B-cell lymphoproliferative process that histopathologically and/or clinically imitates cutaneous lymphoma. We report the case of a 62-year-old woman with a poorly defined, erythematous plaque with papules on the dorsal nose that had been present for years. This lesion was biopsied as an atypical T-cell infiltrate and was clinically diagnosed as a pseudolymphoma. After unsuccessful treatments with mometasone and tacrolimus, the patient was started on tapinarof cream 1%. After 10 months of treatment, there was clinical improvement of the plaque and papules with only slight residual erythema. Further studies and reports will help elucidate the role of tapinarof as a therapeutic option for pseudolymphoma. Based on its safety profile and promising results in other inflammatory and hyperproliferative disorders, it could be considered in refractory cases.