Photoaccentuated erythroderma associated with CD4+ T lymphocytopenia: successful treatment with 5-methoxypsoralen and UVA, interferon alfa-2b, and extracorporeal photopheresis.

Abstract

We describe a 53-year-old HIV-negative white man who had chronic CD4+ T lymphocytopenia and photoaccentuated erythroderma with lymphoma-like histologic changes. The erythroderma completely responded to 5-methoxypsoralen and UVA (PUVA), interferon alfa-2b, and extracorporeal photopheresis. During therapy opportunistic skin infections, including tinea corporis, warts, and disseminated molluscum contagiosum, developed. Although the patient met the current definition of idiopathic CD4+ T lymphocytopenia (ICTL), we cannot rule out the possibility that this peripheral CD4+ T lymphocytopenia resulted from sequestration of CD4+ T lymphocytes in erythrodermic skin.

• Authors: P Wolf, R Müllegger, L Cerroni, R Aigner, G Fueger, G Höfler, J Derbaschnig, H Kerl
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 35 Issue 2 Pt 2 Pg. 291-4 (Aug 1996) ISSN: 0190-9622 [Print] United States
• PMID: 8698908 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Interferon alpha-2
• Interferon-alpha
• Recombinant Proteins
• 5-Methoxypsoralen
• Methoxsalen

Topics

• 5-Methoxypsoralen
• Dermatitis, Exfoliative (drug therapy, pathology)
• HIV Seronegativity
• Humans
• Interferon alpha-2
• Interferon-alpha (therapeutic use)
• Lymphoma, T-Cell, Cutaneous (pathology)
• Male
• Methoxsalen (analogs & derivatives, therapeutic use)
• Middle Aged
• Molluscum Contagiosum (etiology)
• Opportunistic Infections (etiology)
• PUVA Therapy
• Photopheresis
• Photosensitivity Disorders (drug therapy, pathology)
• Recombinant Proteins
• Skin Neoplasms (pathology)
• T-Lymphocytopenia, Idiopathic CD4-Positive (drug therapy, pathology)
• Tinea (etiology)
• Warts (etiology)