Cutaneous T-cell lymphoma in the setting of anti-tumor necrosis factor and immunomodulator therapy: A case report and literature review

Abstract

Immunosuppressive therapy is well recognized as increasing the risk of lymphoma. Mycosis fungoides is a rare cutaneous form of T-cell lymphoma with a largely unknown etiology and not typically associated with immunosuppression. In this article, we describe our encounter with a 24-year-old male with Crohn’s disease in remission on immunotherapy, specifically dual therapy with azathioprine and infliximab, presenting with a facial rash found to be consistent with mycosis fungoides on biopsy. The patient’s rash resolved with treatment of topical steroids. In addition, the decision was made to discontinue his azathioprine to minimize his risks of developing future malignancies.

Perforated small bowel lymphoma: a rare presentation of Crohn’s disease

“…Malignant lymphoma of the gastrointestinal tract is a rare condition; in most cases, it takes place within the stomach and can affect the colon or small intestine [ 1 ]. About 70% of Crohn's disease (CD) patients will need surgery to help ease their symptoms, even with advanced medical treatments [ 2 ]. Patients with inflammatory bowel disease (IBD), especially those undergoing immunosuppressive therapy, have shown a higher occurrence of non-Hodgkin's lymphoma [ 1 ].…”

The Temporal Relationships and Associations between Cutaneous Manifestations and Inflammatory Bowel Disease: A Nationwide Population-Based Cohort Study

“…The most commonly reported cases of lymphoma associated with IBD were hepatosplenic T cell lymphoma and non-Hodgkin’s B cell lymphoma, which often developed following the use of TNF-α antagonists and immunosuppressants [ 37 , 38 ]. The case of CTCL was reported recently following use of infliximab and azathioprine for IBD [ 39 ]. Whether IBD alone is an independent risk factor for the development of lymphoma remains controversial [ 37 , 38 ].…”