Infections Complicating Mycosis Fungoides and Sézary Syndrome

Abstract

Community-acquired bacterial skin infections are a common cause of morbidity in patients with mycosis fungoides and Sézary syndrome but are usually treated without hospital admission. Bacteremia and pneumonia, which are usually nosocomial, are the major infectious causes of death. Advanced disease stage, independent of corticosteroids and other therapies, is the most important risk factor for both cutaneous and systemic infections.

Angiogenin levels are increased in lesional skin and sera in patients with erythrodermic cutaneous T cell lymphoma

“…An investigation of complications related to kidney diseases, where there is an impaired host defense, led to the discovery of a degranulation inhibitory protein, which was identical to angiogenin [22]. Interestingly, erythrodermic CTCL patients, who show elevated levels of angigogenin in the skin and sera, are frequently susceptible to the infection by bacterial, viral, and fungal pathogens [3]. As angiogenin expression is stimulated by the RNA likely to be released during apoptotic and necrotic cell damage [9], repetitive infection, in turn, can result in tissue damage leading to elevated angiogenin levels in patients with erythrodermic CTCL.…”

Primary cutaneous T-cell lymphoma expressing FOXP3: A case report supporting the existence of malignancies of regulatory T cells

“…Based on these findings, the authors speculated that the adoption of a Treg phenotype by the CTCL cells offered an explanation for the immunosuppression that accompanies the evolution of the disease. Patients with advanced CTCL frequently die of opportunistic infections, 19 indicating that they have a compromised immune system, a disease feature consistent with the immunosuppressive nature of Tregs. 20 Theoretically, the Treg CTCL cell immunosuppression may target the antitumor cytotoxic T-cell response and may be mediated through secretion of various soluble inhibitory factors, particularly interleukin-10 21 and transforming growth factor-b.…”

Validity assessment of the cutaneous T-cell lymphoma severity index to predict prognosis in advanced mycosis fungoides/Sézary syndrome

“…Patients with cause of death likely related to their cutaneous malignancy, such as a wound infection/sepsis or pulmonary embolism, were deemed to have died of CTCL. 11 Those patients who died of other unrelated causes including cardiovascular events or trauma were not considered to have died of their disease. 11 Data were entered into a Microsoft Access database (Microsoft Corporation), with all patient identification information placed in a separate spreadsheet.…”

“…11 Those patients who died of other unrelated causes including cardiovascular events or trauma were not considered to have died of their disease. 11 Data were entered into a Microsoft Access database (Microsoft Corporation), with all patient identification information placed in a separate spreadsheet. Data were then analyzed by the statistical program STATA (StataCorp, College Station, TX).…”