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Cutaneous atypical papular CD 8+ lymphoproliferative disorder at acral sites in a renal transplant patient
Author(s) -
Baykal C.,
Büyükbabani N.,
Seçkin D.,
Polat Ekinci A.,
Yılmaz Z.,
Kempf W.
Publication year - 2017
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/ced.13220
Subject(s) - medicine , immunosuppression , asymptomatic , lymphoproliferative disorders , dermatology , lymphoma , post transplant lymphoproliferative disorder , pathology , immunology , rituximab
Summary A 20‐year‐old woman presented with a 2‐month history of an acute symmetrical eruption, manifesting as asymptomatic ill‐defined erythematous macules and hyperkeratotic papules on the palms. The patient was a renal transplant recipient, and the lesions had developed 2 months post‐transplantation. Histologically, the eruption shared features of a reactive inflammatory condition called papular eruption of atypical CD 8+ lymphocytes as well as primary cutaneous acral CD8+ T‐cell lymphoma (a provisional indolent entity in the new World Health Organisation classification of lymphoid neoplasms, 2016). The latter disorder has been described to occur at acral sites in immunocompetent patients, whereas the former has previously been described only in patients infected with human immunodeficiency virus. The lesions in our patient healed after topical treatment with corticosteroids and alteration of immunosuppressive therapy, supporting the role of immunosuppression in this case. We classified our patient's condition as lying in the spectrum of the aforementioned two conditions, but the relationship between both diseases remains to be clarified. Awareness of these unusual conditions may prevent the use of unnecessary aggressive therapies in similar patients.