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Atypical presentation of adult T-cell leukaemia/lymphoma due to HTLV-1: prurigo nodularis lasting twelve years followed by an acute micropapular eruption.

Abstract : Prurigo nodularis is a pruritic dermatosis of unknown origin. Human T-cell lymphotropic virus type 1 (HTLV-1) causes adult T-cell leukaemia/lymphoma. HTLV-1 is not considered to be a cause of prurigo nodularis. A 52-year-old black man, from the French West Indies, who had had prurigo nodularis for 12 years, presented with a distinct micropapular eruption with the typical pathological picture of epidermotropic T-cell lymphoma. Based on HTLV-1-positive serology and monoclonal integration of HTLV-1 we diagnosed smouldering adult T-cell leukaemia/lymphoma. Re-examination of previous skin biopsies revealed that the disease had been evolving for 12 years. Treatment with alpha-interferon, 3 x 106 units three times a week, associated with zidovudine, 1 g daily, resulted in complete remission within 4 months. When investigating a prurigo nodularis, we therefore recommend: (i) performing HTLV-1 serology if the patient comes from an endemic area; (ii) if positive, performing CD25 staining and looking for a HTLV-1 clonal integration; and (iii) if positive, using a treatment targeting HTLV-1.
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https://hal-pasteur.archives-ouvertes.fr/pasteur-00531222
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Submitted on : Tuesday, November 2, 2010 - 10:44:15 AM
Last modification on : Wednesday, August 19, 2020 - 11:16:45 AM

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Arnaud Duval, Jacqueline Rivet, Isabelle Moulonguet, Olivier Cassar, Félix Agbalika, et al.. Atypical presentation of adult T-cell leukaemia/lymphoma due to HTLV-1: prurigo nodularis lasting twelve years followed by an acute micropapular eruption.. Acta Dermato-Venereologica Supplementum, Society for Publication of Acta Dermato-Venereologica, 2010, 90 (3), pp.287-90. ⟨10.2340/00015555-0846⟩. ⟨pasteur-00531222⟩

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