Granuloma annulare-like skin lesions as an initial manifestation in a Japanese patient with adult T-cell leukemia/lymphoma.
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| Abstract |
Granuloma annulare is characterized by noncaseating dermal granulomas with connective tissue changes. A relationship with hematologic and solid malignancies has been suggested in some cases. We describe a 70-year-old man who had erythematous annular plaques on his elbows, upper extremities, and wrists for a period of 3 months. Histologic examination revealed epithelioid cell granulomas associated with dense atypical lymphocytes in the dermis. Immunohistochemical staining of skin specimens showed a prominent infiltration of CD3+, CD4+, CD5+, and CD25+ cells. Human T-cell leukemia virus type I proviral DNA was detected in the blood and cerebrospinal fluid by Southern blot analysis and polymerase chain reaction assay. The patient was given the diagnosis of adult T-cell leukemia/lymphoma based on the initial cutaneous manifestations. His condition progressed rapidly and led to his death. The granuloma annulare-like skin lesions in our patient could be considered as a peculiar immunologic hypersensitivity reaction of the host against the tumor cells or persistent human T-cell leukemia virus type I viral antigens. Dermatologists should be aware that this skin condition may be an initial manifestation of adult T-cell leukemia/lymphoma.
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| Authors | Tamihiro Kawakami, Takeshi Kawanabe, Yoshinao Soma |
| Journal | Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 60 Issue 5 Pg. 848-52 (May 2009) ISSN: 1097-6787 [Electronic] United States |
| PMID | 19389526 (Publication Type: Case Reports, Journal Article) |
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