Cutaneous T-cell lymphoma sparing resolving dermatomal herpes zoster lesions: an unusual phenomenon and implications for pathophysiology

Journal of the American Academy of Dermatology
Joy M Twersky, James J Nordlund

Abstract

Exclusion of cutaneous T-cell lymphoma (CTCL) by another dermatosis has not been reported. The mechanism for the epidermotropism of helper T lymphocytes in this indolent malignancy is not known. Although there is evidence that Langerhans cells (LC) play a role in the epidermotropism of lymphocytes in CTCL, clinical or in vivo support is lacking. We describe a patient with CTCL who developed herpes zoster involving the left T8 dermatome. When his CTCL became widespread after the herpes zoster healed, the previously affected areas of herpes zoster and their periphery were clinically free of lymphoma. Immunohistochemical analysis of a clinically uninvolved patch revealed absence of CD1a(+) cells in the epidermis, consistent with loss of LC in the areas spared by CTCL. There was no loss of LC in areas affected by CTCL. This is an unusual inhibition of CTCL by a prior viral infection. The loss of LC in the clinically spared skin suggests a role for LC in the epidermotropism of lymphocytes in CTCL.

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Citations

Jan 26, 2013·The American Journal of Dermatopathology·Ossama Abbas, Meera Mahalingam
Mar 28, 2007·Epilepsia·Gaetano ZaccaraEmilio Perucca
Jul 30, 2009·Journal of Cutaneous Pathology·Ossama Abbas, Jag Bhawan
Jun 25, 2009·Journal of the European Academy of Dermatology and Venereology : JEADV·V RuoccoE Ruocco
Mar 15, 2011·Clinics in Dermatology·Ronni WolfVincenzo Ruocco
Dec 28, 2017·The Australasian Journal of Dermatology·Simo HuangMadeleine Duvic
Feb 3, 2018·Indian Journal of Dermatology, Venereology and Leprology·Surabhi SinhaArvind Ahuja

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