title: Type of skin eruption is an independent prognostic indicator for adult T-cell leukemia/lymphoma.
abstract: Cutaneous involvement is seen in ~ 50% of adult T-cell leukemia/lymphoma (ATLL) patients. We investigated the association between skin eruption type and prognosis in 119 ATLL patients. ATLL eruptions were categorized into patch (6.7%), plaque (26.9%), multipapular (19.3%), nodulotumoral (38.7%), erythrodermic (4.2%), and purpuric (4.2%) types. When the T stage of the tumor-node-metastasis-blood (TNMB) classification of mycosis fungoides/Sézary syndrome was applied to ATLL staging, 16.0% were T1, 17.7% T2, 38.7% T3, and 4.2% T4, and the remaining 23.5% were of the multipapular and purpuric types. For the patch type, the mean survival time (median survival time could not be estimated) was 188.4 months. The median survival times (in months) for the remaining types were as follows: plaque, 114.9; multipapular, 17.3; nodulotumoral, 17.3; erythrodermic, 3.0; and purpuric, 4.4. Kaplan-Meier curves of overall survival showed that the erythrodermic type had the poorest prognosis, followed by the nodulotumoral and multipapular types. The patch and plaque types were associated with better survival rates. Multivariate analysis demonstrated that the hazard ratios of the erythrodermic and nodulotumoral types were significantly higher than that of the patch type, and that the eruption type is an independent prognostic factor for ATLL. The overall survival was worse as the T stage became more advanced: the multipapular type and T2 were comparable, and the purpuric type had a significantly poorer prognosis than T1.
authors.affiliation: Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan. hinoti@med.uoeh-u.ac.jp
authors.forename: Yu
authors.initials: Y
authors.lastname: Sawada
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Hino
authors.forename: Kayo
authors.initials: K
authors.lastname: Hama
authors.forename: Shun
authors.initials: S
authors.lastname: Ohmori
authors.forename: Haruna
authors.initials: H
authors.lastname: Fueki
authors.forename: Shigenori
authors.initials: S
authors.lastname: Yamada
authors.forename: Shoko
authors.initials: S
authors.lastname: Fukamachi
authors.forename: Makiko
authors.initials: M
authors.lastname: Tajiri
authors.forename: Rieko
authors.initials: R
authors.lastname: Kubo
authors.forename: Manabu
authors.initials: M
authors.lastname: Yoshioka
authors.forename: Daiki
authors.initials: D
authors.lastname: Nakashima
authors.forename: Kazunari
authors.initials: K
authors.lastname: Sugita
authors.forename: Ryutaro
authors.initials: R
authors.lastname: Yoshiki
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Shimauchi
authors.forename: Tomoko
authors.initials: T
authors.lastname: Mori
authors.forename: Kunio
authors.initials: K
authors.lastname: Izu
authors.forename: Miwa
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Motonobu
authors.initials: M
authors.lastname: Nakamura
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Tokura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000145:classification / Q000401:mortality* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012867:Skin / Q000473:pathology*; D012878:Skin Neoplasms / Q000145:classification / Q000401:mortality* / Q000473:pathology*; D055815:Young Adult