Primary Cutaneous CD30+ Large T-Cell Lymphoma in a Patient with Psoriasis Treated with Cyclosporine

Abstract

We report the case of a 61-year-old woman who developed an anaplastic CD30+ cutaneous T-cell lymphoma during oral cyclosporine (CsA) therapy for recalcitrant psoriasis. Two months after CsA discontinuation, clinical and histological resolution of the lymphoma was observed. However, 3 years later extracutaneous involvement of the lymphoma could be detected. The association between CsA administration and the occurrence of the lymphoma may be casual, but a relationship with immunosuppression may also be hypothesized. We have reviewed all relevant data in the literature. To our knowledge, this is the first case of primary cutaneous CD30+ anaplastic large T-cell lymphoma in a patient treated with CsA for psoriasis.

The risk of cancer in patients with psoriasis: A population-based cohort study in Taiwan

“…4,5 Broadband and narrowband UVB do not appear to increase the risk of squamous cell carcinoma. 36,37 Recently, development of lymphomas after methotrexate [38][39][40] and cyclosporine, [41][42][43][44][45][46][47] and remission of lymphomas after withdrawal of these drugs [48][49][50][51] in psoriasis patients have been reported. We demonstrated that PUVA and systemic therapies do not significantly increase the risk of cancer.…”

The use of cyclosporine in dermatology: Part II

“…There have been isolated case reports of the development of B-and T-cell lymphomas in psoriasis patients treated with cyclosporine. [116][117][118][119] It is important to note, however, that psoriasis causes a state of chronic overactivation of the immune system with a higher incidence of lymphoma and other malignancies than the normal population. 120,121 Cyclosporine has been shown to promote EpsteineBarr virus (EBV) transformation of human peripheral blood lymphocytes.…”

Treatments for psoriasis and the risk of malignancy

“…These results have been substantiated in case reports that have shown CsA to be potentially associated with a variety of cancers from large T-cell lymphomas to Waldenström macroglobulinemia. [57][58][59][60][61][62][63] Mycophenolate mofetil MMF (Cellcept) was approved by the Food and Drug Administration in 1995 for prophylaxis against organ rejection in transplant patients. Once ingested, MMF undergoes ester hydrolysis to form mycophenolic acid, a weak organic acid that has been evaluated since the 1970s as a potential anti-psoriatic treatment.…”