Mycosis Fungoides-Type Cutaneous T-Cell Lymphoma and Neutrophilic Dermatosis

Franck, N.; Carlotti, A.; Gorin, I.; Buffet, M.; Mateus, Christine; Dupin, Nicolas

doi:10.1001/archderm.141.3.353

Cited by 16 publications

(11 citation statements)

References 16 publications

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“…The association between Sweetís syndrome and leukemia is well-known and corresponds to the majority of cases of malignancy; however, lymphoma is rare. [10][11][12][13][14][15] The association between Hodgkinís lymphoma and Sweetís syndrome is even rarer. To the best of our knowledge, this is only the fifth report of such a case.…”

Section: Discussionmentioning

confidence: 99%

Síndrome de Sweet: estudo de 73 casos, com ênfase nos achados histopatológicos

Rochael

Pantaleão

Vilar

et al. 2011

An. Bras. Dermatol.

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BACKGROUND: Sweet's syndrome refers to a set of cutaneous, systemic and histopathological alterations that occur in response to different stimuli, in a similar way to that occurring in erythema nodosum, erythema multiforme and leukocytoclastic vasculitis. The syndrome has been described in association with conditions such as infections, pregnancy, the use of certain medications and malignancy. OBJECTIVES: To evaluate the clinical and histopathological alterations occurring in this syndrome and to assess the association between these alterations and other conditions. METHODS: A retrospective study of 73 cases was conducted, evaluating data on the microscopic examination of skin lesions, as well as clinical and laboratory data. RESULTS: The majority of the patients were female (83.0%), white (49.2%) and between 30 and 60 years of age (73.8%). The principal alterations found were: erythymatous plaques (76.9%), papules (43.0%), pseudo-vesiculation (PV) (38.4%) and target lesions (18.5%). With respect to the associated conditions, upper respiratory tract infections (15.4%) and the use of medication (10.8%) were the most common. Other associations, albeit represented by only one case each, were: Hodgkin's lymphoma, pregnancy, ulcerative colitis, polycythemia vera and lupus erythematosus in a patient with acquired immune deficiency syndrome (AIDS). The principal microscopic findings were: neutrophils with leukocytoclasia (98.6%), collagen degeneration (87.7%), edema (74.0%) and PV (38.4%). The presence of eosinophils (41.1%) ranged from rare to abundant and was usually unrelated to the use of medication. Inflammatory infiltrate reached the deep epidermal layer in 47.9% of cases and panniculitis was found in 80.0% of cases in which the hypodermis was affected (10 cases). CONCLUSIONS: In general, these findings are in agreement with results published in the literature, emphasizing the frequent finding of eosinophils unrelated to drug use, panniculitis and the rare association with Hodgkin's lymphoma. This is the fifth report of an association between Sweet's syndrome and Hodgkin's disease. Keywords: Erythema Multiforme; Hodgkin's Disease; Panniculitis; Sweet's Syndrome.Resumo: FUNDAMENTOS: A síndrome de Sweet corresponde a um conjunto de alterações cutâneas, sistêmicas e histopatológicas como resposta a diversos estímulos, semelhantes ao eritema nodoso, ao eritema multiforme e à vasculite leucocitoclásica. São descritas condições associadas como infecção, gravidez, uso de drogas e malignidades. OBJETIVOS: Avaliar as alterações clínicas e histopatológicas da síndrome, relacionando-a a outras condições. MÉTODO: Estudo retrospectivo de 73 casos com avaliação microscópica de lesões cutâneas, dados clínicos e laboratoriais. RESULTADOS: Houve predomínio de mulheres (83,0%), brancas (49,2%), entre a quarta e a sexta décadas de vida (73,8%). Placas eritematosas (76,9%), pápulas (43,0%), pseudovesiculação (PV) (38,4%) e lesões em alvo (18,5%) foram as principais alterações. Entre as condições associadas, infecções de vi...

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Section: Discussionmentioning

confidence: 99%

Síndrome de Sweet: estudo de 73 casos, com ênfase nos achados histopatológicos

Rochael

Pantaleão

Vilar

et al. 2011

An. Bras. Dermatol.

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“…High expression of IL-17F has been associated with significantly increased risk of disease progression independently of disease stage, sex, and age at the time of diagnosis and IL-17A with neutrophil infiltration in CTCL lesions [62, 70]. In agreement, marked infiltration of neutrophils is only observed in a subset of CTCL patients and their accumulation has been associated with an aggressive disease course [70, 74]. IL-22 has been reported to correlate with the expression of CCL20 in CTCL lesions, and siRNA-mediated knockdown of IL-22 receptor alpha (IL-22RA) in malignant CTCL cells inhibited the expression of CCL20, providing a possible link between IL-22, the CCR6-CLL20 axis, and malignant dissemination [55, 56].…”

Section: The Expression Of Pro-tumorigenic Cytokines Increases Duringmentioning

confidence: 97%

“…This raises the possibility that malignant T cells, through the attraction and activation of eosinophils, may fuel their own growth indirectly by boosting neovascularization and a deregulated Th2 response [128]. Marked infiltration of neutrophils is only occasionally seen in CTCL, but detection of neutrophilic dermatoses has been associated with an aggressive disease course [70, 74]. As already mentioned, L-17A and IL-17F are expressed in the lesional skin in a subset of CTCL patients and known to stimulate recruitment of neutrophils [62, 70, 71].…”

Section: The Malignant T Cells Foster Pro-tumorigenic Inflammation Thmentioning

confidence: 99%

Malignant inflammation in cutaneous T‐cell lymphoma—a hostile takeover

et al. 2016

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Cutaneous T-cell lymphomas (CTCL) are characterized by the presence of chronically inflamed skin lesions containing malignant T cells. Early disease presents as limited skin patches or plaques and exhibits an indolent behavior. For many patients, the disease never progresses beyond this stage, but in approximately one third of patients, the disease becomes progressive, and the skin lesions start to expand and evolve. Eventually, overt tumors develop and the malignant T cells may disseminate to the blood, lymph nodes, bone marrow, and visceral organs, often with a fatal outcome. The transition from early indolent to progressive and advanced disease is accompanied by a significant shift in the nature of the tumor-associated inflammation. This shift does not appear to be an epiphenomenon but rather a critical step in disease progression. Emerging evidence supports that the malignant T cells take control of the inflammatory environment, suppressing cellular immunity and anti-tumor responses while promoting a chronic inflammatory milieu that fuels their own expansion. Here, we review the inflammatory changes associated with disease progression in CTCL and point to their wider relevance in other cancer contexts. We further define the term “malignant inflammation” as a pro-tumorigenic inflammatory environment orchestrated by the tumor cells and discuss some of the mechanisms driving the development of malignant inflammation in CTCL.

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“…IL‐17 promotes IL‐6 and IL‐8 production by keratinocytes, fibroblasts and endothelial cells. In some instances, MF is complicated by a neutrophilic dermatosis (ND) that is associated with a poor prognosis 9 . Here we have investigated whether Th17 cells were present in two cases of CTCL associated with ND.…”

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confidence: 99%