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Joan Guitart, MD; Gary S. Wood, MD

Arch Dermatol. 2009;145(7):811-813.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In this issue of the Archives, Weenig et al¹ describe 3 patients with clinically presumed psoriasis with nondiagnostic skin biopsies, whose disease, after a long course, eventually evolved into extensive ulcerative indurated plaques culminating in the patients' deaths. None of them had evidence of systemic lymphoma on physical examination or imaging studies, and bone marrow biopsies were negative for disease. Skin biopsies showed epithelial necrosis and exocytosis of T cells expressing the cytotoxic granule components granzyme B and T-cell intracellular antigen 1. These infiltrates were probably composed of cytotoxic T cells with a CD8⁺ or double-negative (CD4^–/CD8^–) phenotype and had no evidence of Epstein-Barr viral (EBV) integration or dominant T-cell clonality. Although dominant T-cell clonality or internal involvement was never proven, the authors¹ conclude that these patients probably had aggressive cytotoxic lymphomas (CLs). This extensive ulceronecrotic presentation and a fatal . . . [Full Text of this Article]

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Fatal Cytotoxic Cutaneous Lymphoma Presenting as Ulcerative Psoriasis
Roger H. Weenig, Nneka I. Comfere, Lawrence E. Gibson, Javier Alonso-Llamazares, Mark D. P. Davis, Mark R. Pittelkow, and Rokea A. el-Azhary
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