Specific cutaneous manifestations in adult T‐cell leukemia/lymphoma

We describe a case of granulomatous slack skin in a 31-year-old woman with an unusual presentation of acquired ichthyosis and muscular masses involving four limbs over 3 years. Vesicles and ulcerative skin nodules first appeared only 3 months prior to diagnosis. The diagnosis was confirmed after sequential biopsies of muscle, skin lesions, and lymph nodes, together with molecular genetic studies. The patient responded poorly to various therapies, including thalidomide, and died of doxorubicin-related cardiomyopathy.

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“…[10] Granulomatous infiltration from ichthyotic skin has been found in some cases of MF, [7,9] and was present in our patient.…”

Section: Discussionmentioning

confidence: 71%

Granulomatous Slack Skin Presenting as Acquired Ichthyosis and Muscle Masses

Hsiao

Tsai

et al. 2009

American Journal of Clinical Dermatology

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“…Maculo-papular presentation is the most common. Papules, plaques, nodules, tumour, erythrodermia, and ichthyosis-like lesions, have been reported (3). To our knowledge anthralin-triggered eruption has not been reported previously.…”

Section: Discussionmentioning

confidence: 91%

Atypical Presentation of Adult T-cell Leukaemia/Lymphoma due to HTLV-1: Prurigo Nodularis Lasting Twelve Years Followed by an Acute Micropapular Eruption

Duval¹,

Rivet²,

Moulonguet³

et al. 2010

Acta Derm Venerol

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Prurigo nodularis is a pruritic dermatosis of unknown origin. Human T-cell lymphotropic virus type 1 (HTLV-1) causes adult T-cell leukaemia/lymphoma. HTLV-1 is not considered to be a cause of prurigo nodularis. A 52-year-old black man, from the French West Indies, who had had prurigo nodularis for 12 years, presented with a distinct micropapular eruption with the typical pathological picture of epidermotropic T-cell lymphoma. Based on HTLV-1-positive serology and monoclonal integration of HTLV-1 we diagnosed smouldering adult T-cell leukaemia/lymphoma. Re-examination of previous skin biopsies revealed that the disease had been evolving for 12 years. Treatment with alpha-interferon, 3 x 106 units three times a week, associated with zidovudine, 1 g daily, resulted in complete remission within 4 months. When investigating a prurigo nodularis, we therefore recommend: (i) performing HTLV-1 serology if the patient comes from an endemic area; (ii) if positive, performing CD25 staining and looking for a HTLV-1 clonal integration; and (iii) if positive, using a treatment targeting HTLV-1.

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“…Specific cutaneous manifestations (ie, the presence of lymphomatous cells revealed by histopathological analysis of skin biopsy specimens) can be used to identify patients with ATL. 9 To our knowledge, this is the first report of GA-like skin lesions as an initial sign of ATL. The neoplastic T-cell infiltrate of cutaneous ATL lesions may play some role in the GA appearance process.…”

mentioning

confidence: 90%