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Primary cutaneous T cell lymphomas: photochemotherapy immunomodulation with analysis of the inflammatory‐expansive cellular dynamic
Author(s) -
WerberBandeira Luiz,
Herdy Ana Maria,
Pagani Evilmara Adelia,
Filgueira Absalom Lima
Publication year - 2013
Publication title -
dermatologic therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.595
H-Index - 68
eISSN - 1529-8019
pISSN - 1396-0296
DOI - 10.1111/dth.12058
Subject(s) - medicine , mycosis fungoides , cd8 , t cell , pathology , immunophenotyping , expansive , psoralen , immunology , flow cytometry , lymphoma , biology , immune system , compressive strength , materials science , composite material , dna , genetics
Primary cutaneous T cell lymphomas ( CTCLs ) are characterized by hyperproliferation of malignant CD 4+ T cells with primary localization on the skin. The common characteristics are the migration of the malignant mature T ‐lymphocytes into the epidermis, with hyperproliferation of malignant CD 4+ T cells and epidermotropism. S ézary syndrome ( SS ) is the leukemic variant. It was established that CTCLs arise from a clonal expansion of CD4 + T cells with an identical rearrangement of the T cell receptor. The purpose of this study was to evaluate the immunomodulation effect of photochemotherapy‐ A (psoralen plus ultraviolet A ( PUVA )). Pre‐ and post‐ PUVA punch skin biopsies of nine patients were stained immunohistochemically for CD 34+, CD 8+, CD 7+, CD 16+, CD 56+, CD 1a+, B cl2+, p53+, CD 45 RA +, and CD 45 RO + cells. The results showed a pre‐ PUVA cells/mm 2 without significant difference among expansive or reactive cells. Post‐ PUVA analysis showed a significant decrease in the mean of expansive‐reactive cells. PUVA immunomodulated decreasing cellular infiltrate. These findings could contribute to the comprehension of how PUVA acts. We achieved ectoscopic clearance of the lesions, although post‐ PUVA , there still was a mononuclear pathological infiltrate. This result demonstrates that the PUVA treatment should only be withheld when the histological analysis is normal.