Actinic reticuloid simulating sézary syndrome

Toonstra, Johan; Weelden, Huib van; Meyling, F. H. J. Gmelig; Putte, S. C. J. van der; Schiere, S. I. M.; Faille, H. Baart de la

doi:10.1007/bf00404310

Cited by 22 publications

(11 citation statements)

References 19 publications

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“…Reduced MED was noted mainly to UVA and less so to UVB and visible light. Case reports of severe photosensitivity in CTCL have been published, but it is possible that some of these patients represented either the actinic reticuloid form of CAD from the outset or CTCL similar to the cases we describe 19,20 . Of particular note, Sugita et al.…”

Section: Discussionmentioning

confidence: 54%

Case report of four patients with erythrodermic cutaneous T-cell lymphoma and severe photosensitivity mimicking chronic actinic dermatitis

Agar

Morris

Russell‐Jones

et al. 2009

British Journal of Dermatology

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The marked photosensitivity associated with chronic actinic dermatitis (CAD) is presumed to be due to a T cell-mediated response to ultraviolet (UV)-induced epidermal neoantigens. Photosensitivity is, however, a rare occurrence in cutaneous T-cell lymphoma (CTCL). We discuss a series of four patients with erythrodermic CTCL who exhibited marked photosensitivity mimicking CAD. Significantly, the tumour cells had a CD8 phenotype in half of these patients. All patients had T-cell clones in skin and also demonstrated identical peripheral T-cell clones in blood or lymph node involvement. Sézary cell counts ranged from 6% to 20%, CD4/CD8 ratios from 0.22 to 23.5. Clinical presentation was striking for a marked photosensitive distribution. Monochromator irradiation testing revealed reduced minimal erythema doses throughout UVB and UVA ranges, findings consistent with those seen in CAD. All patients subsequently died from systemic disease. These findings suggest that, rarely, malignant clonal T-cell populations may recognize a unique UV-induced neoantigen, resulting in the clinical features of severe photosensitivity mimicking those seen in CAD.

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Section: Discussionmentioning

confidence: 54%

Case report of four patients with erythrodermic cutaneous T-cell lymphoma and severe photosensitivity mimicking chronic actinic dermatitis

Agar

Morris

Russell‐Jones

et al. 2009

British Journal of Dermatology

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“…Previous im munohistological examinations of AR pa tients have shown a preponderance of CD8-positive T lymphocytes in blood and skin infiltrate [13,14], but the pathophysio logical mechanisms are not known. The out come of the disease is rarely malignant although lymphoma has been observed in one person [15], Patients may clinically resemble pre-Sézary syndrome although not in the distribution of T cell subpopulations [13,14], This report adds further evidence to sup port the idea that CS therapy may carry potential risks in a premalignant disorder. The experience from transplant patients has shown an increased incidence of lymphoma in such patients [16].…”

Section: Discussionmentioning

confidence: 99%

Development of Cutaneous Pseudolymphoma Following Ciclosporin Therapy of Actinic Reticuloid

Thestrup‐Pedersen

Zachariae²,

Kaltoft³

et al. 1988

Dermatology

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The patient is a 57-year-old man with actinic reticuloid, who despite systemic prednisone, azathioprine, topical steroid, and sun-protective cream had to stay indoors in the summer of 1986. In February 1987 he was started on ciclosporin (CS), 5.5 mg per kg body weight, and skin symptoms did not develop as usual in spring and summer 1987. Following 4 months of succesful therapy, he developed an indolent tumor on his right chin and parapsoriasis en plaque on the lower arms and legs. Histological examinations of the tumor showed an intense lymphoid infiltrate of a pseudolymphomatous type. The tumor regressed partly following discontinuation of CS, but additional radiation therapy had to be administered. His clinical symptoms of actinic reticuloid reappeared. Eight months after CS treatment he developed a malignant T cell lymphoma with metastasis in the regional lymph nodes on the neck. CS should not be used in diseases with potential premalignant features even though its therapeutic efficacy in actinic reticuloid was impressive.

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“…Among them, one patient (No. [9][10][11][12] Rarely, some patients with CTCL may have marked photosensitivity as in CAD. 1d-f).…”

Section: Discussionmentioning

confidence: 99%

“…As previously described, patients with severe CAD or actinic reticuloid may mimic CTCL clinically. [9][10][11][12] Rarely, some patients with CTCL may have marked photosensitivity as in CAD. 13 In addition, CAD might develop in patients with ATLL as previously reported.…”

Section: Discussionmentioning

confidence: 99%

Phenotypic analysis of circulating T‐cell subset and its association with burden of skin disease in patients with chronic actinic dermatitis: a hematologic and clinicopathologic study of 20 subjects

et al. 2017

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Actinic reticuloid simulating sézary syndrome

Cited by 22 publications

References 19 publications

Case report of four patients with erythrodermic cutaneous T-cell lymphoma and severe photosensitivity mimicking chronic actinic dermatitis

Case report of four patients with erythrodermic cutaneous T-cell lymphoma and severe photosensitivity mimicking chronic actinic dermatitis

Development of Cutaneous Pseudolymphoma Following Ciclosporin Therapy of Actinic Reticuloid

Phenotypic analysis of circulating T‐cell subset and its association with burden of skin disease in patients with chronic actinic dermatitis: a hematologic and clinicopathologic study of 20 subjects

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