Primary Cutaneous CD30+ Anaplastic Large T Cell Lymphoma in a Patient Treated with Cyclosporine for Actinic Reticuloid

Abstract

Actinic reticuloid (AR)—a subtype of chronic actinic dermatitis—clinically and histopathologically shows lymphoma-like features. We report a male patient initially diagnosed with erythrodermic cutaneous T cell lymphoma (CTCL) who developed severe broadband photosensitivity. Clinical evaluation, histopathology, and phototesting were consistent with AR. The patient was treated with cyclosporine 150–300 mg/d. Under this therapy, he developed several times primary cutaneous anaplastic large cell lymphomas (C-ALCL) which in part tended to regress spontaneously under cyclosporine reduction. The association between cyclosporine treatment and development of C-ALCL and other CD30+ lymphoproliferative disorders has previously been reported in patients with atopic dermatitis, psoriasis, and transplant patients. In conclusion, the present case highlights the difficulties arising in the distinction between AR and CTCL and shows that long-term cyclosporine treatment may cause C-ALCL development in AR as well.

Mogamulizumab efficacy is underscored by its associated rash that mimics cutaneous T-cell lymphoma: a retrospective single-centre case series

“…Some immunosuppressive drugs we used as MAR-directed therapy have been linked with CTCL exacerbation, including ciclosporin and dupilumab. [34][35][36][37][38] They are theorized to lower or ameliorate any remaining level of antitumour host response, and are thus contraindicated in patients with CTCL. However, we recently published a case report detailing the successful use of dupilumab as a MAR-directed therapy, with special consideration of several conflicting reports of dupilumab when used as a CTCL-directed therapy.…”

“…Some immunosuppressive drugs we used as MAR‐directed therapy have been linked with CTCL exacerbation, including ciclosporin and dupilumab 34–38 . They are theorized to lower or ameliorate any remaining level of antitumour host response, and are thus contraindicated in patients with CTCL.…”

Clinical characteristics of patients with human immunodeficiency virus and immune‐mediated photodermatoses: A retrospective study of 39 patients

“…Primary treatment of HIV‐related photosensitive dermatosis is HAART and sun avoidance; secondary supportive treatment is required according to initial lesions and the progression. Cyclosporin, thalidomide, and mycophenolate mofetil are helpful 33–36 …”

LncRNA‐WAKMAR2 regulates expression of CLDN1 to affect skin barrier through recruiting c‐Fos

“…Chronic actinic dermatitis (CAD) is an immune-mediated photoallergic skin disease accompanied with skin barrier dysfunction, which can be converted into cutaneous lymphoma in severe cases. 1 This disease seriously affects both physical and mental health, and reduces the quality of life of patients. 2 Recent reports have shown that with the increase of climate change and environmental pollution, the incidence of CAD has shown a significant upward trend.…”

“…Chronic actinic dermatitis (CAD) is an immune‐mediated photoallergic skin disease accompanied with skin barrier dysfunction, which can be converted into cutaneous lymphoma in severe cases 1 . This disease seriously affects both physical and mental health, and reduces the quality of life of patients 2 .…”