Photoaccentuated erythroderma associated with CD4+ T lymphocytopenia: successful treatment with 5-methoxypsoralen and UVA, interferon alfa-2b, and extracorporeal photopheresis.
We describe a 53-year-old HIV-negative white man who had chronic CD4+ T lymphocytopenia and photoaccentuated erythroderma with lymphoma-like histologic changes. The erythroderma completely responded to 5-methoxypsoralen and UVA (PUVA), interferon alfa-2b, and extracorporeal photopheresis. During therapy opportunistic skin infections, including tinea corporis, warts, and disseminated molluscum contagiosum, developed. Although the patient met the current definition of idiopathic CD4+ T lymphocytopenia (ICTL), we cannot rule out the possibility that this peripheral CD4+ T lymphocytopenia resulted from sequestration of CD4+ T lymphocytes in erythrodermic skin.
Wolf
P
P
Department of Dermatology, Karl Franzens University, Graz, Austria.
Müllegger
R
R
Cerroni
L
L
Aigner
R
R
Fueger
G
G
Höfler
G
G
Derbaschnig
J
J
Kerl
H
H
D000078223:5-Methoxypsoralen; D003873:Dermatitis, Exfoliative / Q000188:drug therapy / Q000473:pathology*; D018023:HIV Seronegativity; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D016410:Lymphoma, T-Cell, Cutaneous / Q000473:pathology; D008297:Male; D008730:Methoxsalen / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D008976:Molluscum Contagiosum / Q000209:etiology; D009894:Opportunistic Infections / Q000209:etiology; D011701:PUVA Therapy; D017893:Photopheresis; D010787:Photosensitivity Disorders / Q000188:drug therapy / Q000473:pathology*; D011994:Recombinant Proteins; D012878:Skin Neoplasms / Q000473:pathology; D018344:T-Lymphocytopenia, Idiopathic CD4-Positive / Q000188:drug therapy / Q000473:pathology*; D014005:Tinea / Q000209:etiology; D014860:Warts / Q000209:etiology
D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D000078223:5-Methoxypsoralen; D008730:Methoxsalen