title: Heavy metal (monoclonal) bands: a link between cutaneous T-cell lymphoma and contact allergy to potassium dichromate, nickel and cobalt?
abstract: It has been proposed that chronic antigenic stimulation plays a role in the pathogenesis of cutaneous T-cell lymphoma (CTCL). By definition, antigenic stimulation triggers allergic contact dermatitis (ACD). It is therefore plausible that chronic ACD could serve as a precursor to CTCL. We report two cases of contact allergy to potassium dichromate, nickel and cobalt, where CTCL was diagnosed in one patient, and a diagnosis of CTCL is imminent in the other. We also review the literature on the diagnostic criteria for CTCL in the setting of ACD and explore potential mechanisms for the progression from ACD tos CTCL.
authors.affiliation: Department of Dermatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Dev
authors.initials: D
authors.lastname: Tilakaratne
authors.forename: Shireen
authors.initials: S
authors.lastname: Sidhu
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003035:Cobalt / Q000009:adverse effects / Q000276:immunology*; D017449:Dermatitis, Allergic Contact / Q000209:etiology* / Q000473:pathology; D015321:Gene Rearrangement; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000235:genetics / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009532:Nickel / Q000009:adverse effects / Q000276:immunology*; D011192:Potassium Dichromate / Q000009:adverse effects / Q000276:immunology*; D011948:Receptors, Antigen, T-Cell / Q000235:genetics
chemical_list: D011948:Receptors, Antigen, T-Cell; D003035:Cobalt; D009532:Nickel; D011192:Potassium Dichromate
keywords: CTCL; Sézary syndrome; allergic contact dermatitis; chronic antigenic stimulation; cobalt; cutaneous T-cell lymphoma; extracorporeal photophoresis; monoclonal T-cell proliferation; nickel; potassium dichromate