CD30(+) cutaneous lymphoma in association with atopic eczema

Arch Dermatol. 2004 Apr;140(4):449-54. doi: 10.1001/archderm.140.4.449.

Abstract

Background: Chronic atopic eczema is not regarded as a precursor of malignancy, and, to our knowledge, there has been only one previous case report of CD30(+) cutaneous lymphoma in association with atopic dermatitis.

Observations: We report 4 cases of CD30(+) lymphoproliferative disease in young adult patients with active atopic eczema dating from early childhood. Three patients developed primary cutaneous anaplastic large cell lymphoma, of whom 2 developed systemic disease and 1 died. The other patient developed lymphomatoid papulosis type A, which resolved after withdrawal of cyclosporine therapy. No other patient had received immunosuppressive therapy. Three had been treated with phototherapy, and 2 of these patients exhibited positive immunostaining for p53 within a proportion of the tumor cell population.

Conclusions: Although we have not been able to establish a causative link, we believe that the association of these 2 conditions has not occurred by chance. Biopsies of lesional skin from subjects with atopic eczema exhibit a proportion of CD30 cells, and clonal transformation of this subpopulation might account for the CD30(+) lymphomas in our patients.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers / analysis
  • Biopsy, Needle
  • Dermatitis, Atopic / complications*
  • Dermatitis, Atopic / drug therapy
  • Dermatitis, Atopic / pathology
  • Dermatologic Agents / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Immunosuppressive Agents / therapeutic use
  • Ki-1 Antigen / immunology*
  • Lymphoma, T-Cell, Cutaneous / complications*
  • Lymphoma, T-Cell, Cutaneous / drug therapy
  • Lymphoma, T-Cell, Cutaneous / pathology*
  • Male
  • Risk Assessment
  • Sampling Studies
  • Severity of Illness Index
  • Skin Neoplasms / complications*
  • Skin Neoplasms / drug therapy
  • Skin Neoplasms / pathology*
  • Treatment Outcome

Substances

  • Biomarkers
  • Dermatologic Agents
  • Immunosuppressive Agents
  • Ki-1 Antigen