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Skin manifestations of adult T‐cell leukemia/lymphoma: Clinical, cytological and immunological features
Author(s) -
Tokura Yoshiki,
Sawada Yu,
Shimauchi Takatoshi
Publication year - 2014
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.12328
Subject(s) - lymphoma , malignancy , leukemia , medicine , adult t cell leukemia/lymphoma , pathology , immunology , t cell leukemia
Adult T ‐cell leukemia/lymphoma ( ATLL ) is a malignancy of mature T cells caused by human T ‐cell leukemia virus type I . The endemic areas include J apan, especially in K yushu, the C aribbean, P apua N ew G uinea, S outh A merica and A frica. Approximately 50% of ATLL patients exhibit skin manifestations. Cytologically, ATLL tumor cells are characterized by CD 4 + CD 25 + regulatory T ‐cell phenotype, high expressions of CCR 4, and programmed cell death ( PD )‐1 and PD ‐ligand 1. The skin eruptions are categorized into six types: patch, plaque, multipapular, nodulotumoral, erythrodermic and purpuric. The overall survival of the eruption‐bearing patients was poorer than that of the non‐eruption‐bearing patients in acute, chronic and smoldering types, but the survival levels of both groups were comparable in lymphoma type. The prognosis was poor in the order of: erythrodermic, nodulotumoral, multipapular/purpuric, plaque, then patch. Multivariate analysis revealed that the eruption type is an independent prognostic factor for ATLL . Patients may have other skin manifestations, secondary and infective lesions.