Cutaneous T-cell lymphoma and atopy: is there an association?

Background Case reports have suggested a relationship between atopic diatheses and Sezary syndrome, pre-Sezary syndrome or mycosis fungoides. However, Sezary and pre-Sezary syndromes are rare entities, and this association has never been analysed in greater detail for specific subtypes of cutaneous T-cell lymphoma (CTCL). Objectives To evaluate the prevalence of atopy in subjects with Sezary syndrome, pre-Sezary syndrome or mycosis fungoides, and to compare the rates with the reported prevalence of atopy in the general population. Methods We retrospectively reviewed the records of 157 patients with the diagnosis of Sezary or pre-Sezary syndrome seen between 1965 and 2000, and 102 patients with the diagnosis of mycosis fungoides evaluated from 1994 to 2000 at Mayo Clinic. Results Of 157 subjects with Sezary or pre-Sezary syndrome and 102 subjects with mycosis fungoides, 18 and 12, respectively, were identified as having a history of atopic dermatitis, asthma or allergic rhinitis. The prevalence rates of atopy in Sezary or pre-Sezary syndrome and mycosis fungoides were 11.5% (95% confidence interval 6.9-17.5%) and 11.8% (6.2-19.7%), respectively. Conclusions No significant difference exists in the prevalence of atopy in Sezary or pre-Sezary syndrome compared with that in mycosis fungoides (chi(2)-test, P = 1.00). Furthermore, the rates of atopy in Sezary or pre-Sezary syndrome and mycosis fungoides are not significantly different from the prevalence of atopy in the general population (17-40%). On the basis of these observations, no evidence currently implicates a causal association of CTCL with atopy.