Palpable arciform migratory erythema in an HIV patient, a CD8+ pseudolymphoma.
BACKGROUND
Palpable arciform migratory erythema (PAME) is characterized by large, elevated, reddish annular lesions localized on the upper trunk. As its infiltrate consists predominantly of dense infiltrates of CD4+ lymphocytes with polyclonal T-cell receptor (TCR) gene rearrangement, it has been grouped as a rare member of the T-cell pseudolymphomas.


METHODS
We performed histology, immunophenotyping, and TCR-gamma gene rearrangement studies in an human immunodeficiency virus (HIV)-positive patient, CDC stage IIIB, who showed a clinically typical PAME.


RESULTS
While TCR-gamma gene rearrangement studies showed a polyclonal infiltrate confirming a pseudolymphoma, 85% of skin-infiltrating lymphocytes were CD8+ T cells.


CONCLUSIONS
PAME may also occur in HIV-positive patients with CD4+ deficiency. Our case demonstrates that regular CD4 counts and immunocompetence are not necessary for its pathogenesis.
Muche
J M
JM
Department of Dermatology and Allergy, Medical Faculty (Charité), Humboldt-University Berlin, Schumannstrasse 20/21, 10117 Berlin, Germany.
Toppe
E
E
Sterry
W
W
Haas
N
N
D000328:Adult; D018414:CD8-Positive T-Lymphocytes / Q000473:pathology*; D004890:Erythema / Q000150:complications* / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D015334:Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D019310:Pseudolymphoma / Q000150:complications* / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D012867:Skin / Q000473:pathology