Granuloma annulare-like skin lesions as an initial manifestation in a Japanese patient with adult T-cell leukemia/lymphoma - 07/08/11
Abstract |
Granuloma annulare is characterized by noncaseating dermal granulomas with connective tissue changes. A relationship with hematologic and solid malignancies has been suggested in some cases. We describe a 70-year-old man who had erythematous annular plaques on his elbows, upper extremities, and wrists for a period of 3 months. Histologic examination revealed epithelioid cell granulomas associated with dense atypical lymphocytes in the dermis. Immunohistochemical staining of skin specimens showed a prominent infiltration of CD3+, CD4+, CD5+, and CD25+ cells. Human T-cell leukemia virus type I proviral DNA was detected in the blood and cerebrospinal fluid by Southern blot analysis and polymerase chain reaction assay. The patient was given the diagnosis of adult T-cell leukemia/lymphoma based on the initial cutaneous manifestations. His condition progressed rapidly and led to his death. The granuloma annulare–like skin lesions in our patient could be considered as a peculiar immunologic hypersensitivity reaction of the host against the tumor cells or persistent human T-cell leukemia virus type I viral antigens. Dermatologists should be aware that this skin condition may be an initial manifestation of adult T-cell leukemia/lymphoma.
Le texte complet de cet article est disponible en PDF.Key words : adult T-cell leukemia/lymphoma, granuloma annulare, initial cutaneous manifestations, malignant lymphoma
Abbreviations used : ATL, GA, HTLV
Plan
Funding sources: None. |
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Conflicts of interest: None declared. |
Vol 60 - N° 5
P. 848-852 - mai 2009 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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