CD30(+) cutaneous lymphoma in association with atopic eczema.
BACKGROUND
Chronic atopic eczema is not regarded as a precursor of malignancy, and, to our knowledge, there has been only one previous case report of CD30(+) cutaneous lymphoma in association with atopic dermatitis.


METHODS
We report 4 cases of CD30(+) lymphoproliferative disease in young adult patients with active atopic eczema dating from early childhood. Three patients developed primary cutaneous anaplastic large cell lymphoma, of whom 2 developed systemic disease and 1 died. The other patient developed lymphomatoid papulosis type A, which resolved after withdrawal of cyclosporine therapy. No other patient had received immunosuppressive therapy. Three had been treated with phototherapy, and 2 of these patients exhibited positive immunostaining for p53 within a proportion of the tumor cell population.


CONCLUSIONS
Although we have not been able to establish a causative link, we believe that the association of these 2 conditions has not occurred by chance. Biopsies of lesional skin from subjects with atopic eczema exhibit a proportion of CD30 cells, and clonal transformation of this subpopulation might account for the CD30(+) lymphomas in our patients.
Fletcher
Clair L
CL
Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, England.
Orchard
Guy E
GE
Hubbard
Virginia
V
Whittaker
Sean J
SJ
Edelson
Richard L
RL
Russell-Jones
Robin
R
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D001707:Biopsy, Needle; D003876:Dermatitis, Atopic / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D003879:Dermatologic Agents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017730:Ki-1 Antigen / Q000276:immunology*; D016410:Lymphoma, T-Cell, Cutaneous / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D012878:Skin Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D016896:Treatment Outcome
D015415:Biomarkers; D003879:Dermatologic Agents; D007166:Immunosuppressive Agents; D017730:Ki-1 Antigen