Cutaneous CD8 T cell infiltrates in advanced HIV infection

J Am Acad Dermatol. 1999 Nov;41(5 Pt 1):722-7. doi: 10.1016/s0190-9622(99)70007-1.


Background: Aggressive non-Hodgkin's lymphomas are common among patients infected with HIV. Although such lymphomas are mostly of the B-cell type, various cases of cutaneous T-cell lymphoma (CTCL) have also been reported. Recent reports suggest that some HIV-related lymphoproliferative conditions may not be clonal processes, but polyclonal lymphoid proliferations.

Objective: We reviewed our experience with HIV patients seen at the dermatology clinics for possible CTCL.

Methods: A retrospective study was performed to evaluate clinical, laboratory, and histologic findings of HIV-infected patients with atypical T-cell cutaneous infiltrates.

Results: We observed 9 patients with advanced HIV infection and a cutaneous eruption characterized by a dense infiltrate of lymphocytes resembling mycosis fungoides histopathologically, but composed of CD8(+) cells. Although clonality was not identified in any of the 6 cases tested, 3 patients had similar CD8(+) infiltrates involving lymph nodes or bone marrow. Of the 9 patients, 8 died of AIDS wasting syndrome or infections in less than 1 year.

Conclusion: Cutaneous and systemic infiltrates with polyclonal CD8 T lymphocytes can be seen in patients with advanced HIV infection and profound CD4 lymphopenia. The clinical presentation may resemble CTCL and is associated with a poor outcome.

MeSH terms

  • Adult
  • CD8-Positive T-Lymphocytes*
  • Disease Progression
  • HIV Infections / pathology*
  • Humans
  • Lymphocytes
  • Lymphocytes, Tumor-Infiltrating*
  • Lymphoma, AIDS-Related / pathology*
  • Lymphoma, T-Cell, Cutaneous / pathology*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Skin Neoplasms / pathology*