Aggressive CD30 large cell lymphoma after cyclosporine given for putative atopic dermatitis
Aggressive CD30 large cell lymphoma after cyclosporine given for putative atopic dermatitis
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DOI：
10.1159/000095044
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发表时间：
2006-01-01
期刊：
影响因子：
3.4
通讯作者：
Thomas, Luc
中科院分区：
文献类型：
--
作者：
Mougel, Fanny;Dalle, Stephane;Thomas, Luc
特应性皮炎（AD）不被认为是皮肤T细胞淋巴瘤的易感条件。环孢素（CsA）是治疗AD的有效药物，其副作用包括淋巴细胞增生；都是在这种情况下使用的低剂量。迄今为止，已有3例患者在CsA治疗特应性下发生皮肤T细胞淋巴瘤。一位有AD病史的成年患者因非典型的爆发而接受了CsA治疗。他迅速发展为丘疹性非典型病变，随后出现体积较大的皮肤肿瘤，最终诊断为蕈样真菌病（MF），转化为CD30+大细胞淋巴瘤，伴有淋巴结和血液浸润。停用CsA后未见好转，需行化疗和同种异体移植。本病例说明了在AD假设下的CsA下MF的戏剧性演变。它强调，在非典型AD的情况下，应该进行皮肤活检，以排除MF，并在免疫抑制治疗下避免这种侵袭性发展。版权所有(c) 2006 S. Karger AG，巴塞尔。
Atopic dermatitis (AD) is not regarded as a predisposing condition for cutaneous T cell lymphoma. Cyclosporine (CsA) is an efficient therapy in AD, and its side effects including lymphocytic proliferation, are;are at the low dose used in such cases. So far 3 cases of patients who developed cutaneous T cell lymphoma under CsA treatment for atopy have been described. An adult patient with a history of AD received CsA therapy because of an atypical flare-up of his eruption. He rapidly developed papular atypical lesions, then followed by the onset of a voluminous cutaneous tumor leading to the diagnosis of mycosis fungoides (MF) transformed in CD30+ large cell lymphoma with nodal and blood involvement. No improvement occurred after withdrawing of CsA, and he required a polychemotherapy and an allograft. This case illustrates the dramatic evolution of an MF under CsA given in the hypothesis of AD. It stresses the fact that skin biopsies should be taken in case of atypical AD to rule out MF and avoid such an aggressive evolution under immunosuppressive therapy. Copyright (c) 2006 S. Karger AG, Basel.