Journal
DERMATOLOGY
Volume 206, Issue 2, Pages 157-160Publisher
KARGER
DOI: 10.1159/000068460
Keywords
adult T-cell leukemia/lymphoma; cutaneous granuloma; human T-lymphotropic virus type 1; T-cell receptor gene rearrangement
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A 59-year-old Japanese woman showed recurrent violaceous, indurated erythemas and papules on the buttocks and extremities for a period of 7 years. The lesions showed histologically epithelioid cell granulomas associated with lymphocytes. After 7 years, the patient developed adult T-cell leukemia (ATL), of the acute type, the course of which was fatal. Immunohistochemical staining of the skin sections of granulomatous lesions showed prominent infiltration of CD25-positive cells. Human T-lymphotropic virus type I proviral DNA and monoclonal T-cell receptor 0 gene rearrangement were detected in the skin samples by a retrospectively performed gene analysis. We believe that the patient initially had an unusual cutaneous type of ATL in which granulomas occurred as a host-protective response against ATL progression. Copyright (C) 2003 S. Karger AG, Basel.
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