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A CD8⁺ Variant of Mycosis Fungoides?

Reinhard Dummer, MD; Jivko Kamarashev, MD; Werner Kempf, MD; Andreas C. Häffner, MD; Monika Hess-Schmid, MD; Günter Burg, MD

Arch Dermatol. 2002;138:199-203.

Objective  To evaluate the clinical and prognostic features in primary cutaneous CD8⁺ T-cell lymphomas, which are rare and considered to be aggressive cutaneous lymphoproliferative disorders.

Design  Single-center retrospective study.

Setting  Lymphoma clinic (referral center) of a university hospital.

Patients  Three patients presented with CD8⁺ cutaneous lymphoma characterized by a patchlike pattern and hyperpigmentation.

Results  Histological analysis revealed a CD3⁺, CD8⁺ small-cell infiltrate showing a remarkable affinity to the dermoepidermal junction zone. Clonality for the T-cell receptor chain was detected by polymerase chain reaction followed by denaturing gradient gel electrophoresis. The clinical presentation lasted several years (6 and 9 years, respectively) before the correct diagnosis was made. Treatment with nontoxic approaches (UV-B and local steroids) was successful. Aggressive clinical behavior was not observed.

Conclusions  Our 3 cases of junctional CD8⁺ cutaneous T-cell lymphomas were characterized by hyperpigmentation and nonaggressive clinical behavior. This type of lymphoma, which can be considered a CD8⁺ mycosis fungoides variant, must be distinguished from other types of cutaneous CD8⁺ lymphomas so that overtreatment can be avoided.

From the Department of Dermatology, University of Zurich Medical School, Zurich, Switzerland.

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