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Maarten H. Vermeer, MD; Cornelis P. Tensen, PhD; Petra M. van der Stoop; Hans W. van Oostveen, PhD; Marianne Lund; Rik J. Scheper, PhD; Rein Willemze, MD, PhD

Arch Dermatol. 2001;137:901-905.

Background  Previous studies demonstrating that the neoplastic cells in Sézary syndrome and tumor stage mycosis fungoides express interleukin 4 (IL-4), IL-5, and IL-10 have resulted in the concept that cutaneous T-cell lymphomas are derived from CD4⁺ T cells with a T_H2 type cytokine profile.

Objective  To determine the cytokine profile in CD30^- primary cutaneous large T-cell lymphomas, which represent a subgroup of cutaneous T-cell lymphoma with an aggressive clinical behavior (5-year survival rate of 15%).

Design and Methods  Seven biopsy specimens were taken from 4 patients with CD30^- primary cutaneous large T-cell lymphomas and studied for the expression of T_H1 (IL-2 and interferon ) and T_H2 (IL-4, IL-5, IL-10) cytokines using a reverse transcription–polymerase chain reaction technique. Skin biopsy specimens from patients with Sézary syndrome, mycosis fungoides, atopic dermatitis, or psoriasis were included as controls.

Results  In the 7 CD30^- primary cutaneous large T-cell lymphomas showing an almost pure population of large tumor cells (>90%), no expression of IL-4 was found, and IL-5 was only found in 1 of 7 cases. In control biopsy specimens, expression of IL-4 and/or IL-5 was demonstrated in atopic dermatitis (3/3), tumor stage mycosis fungoides (2/2), and Sézary syndrome (3/3), but not in plaque stage mycosis fungoides.

Conclusion  Our results demonstrate that CD30^- primary cutaneous large T-cell lymphomas do not produce T_H2 cytokines, illustrating that not all cutaneous T-cell lymphomas have a T_H2 cytokine profile.

From the Departments of Dermatology (Drs Vermeer, Tensen, van Oostveen, and Willemze and Ms van der Stoop) and Pathology (Drs Tensen, van Oostveen, and Scheper), Free University Hospital, Amsterdam, the Netherlands; and Department of Dermatology, Marselisborg Hospital, Aarhus, Denmark (Ms Lund).

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