RESUMEN
Pagetoid reticulosis (Woringer-Kolopp disease) is a rare subtype of cutaneous CD8-positive T-cell lymphoma. A 41-year-old man presented with a 7-year history with a slowly progressive erythematous plaque on his right buttocks. With the working diagnosis of psoriasis, he was treated with topical corticosteroids which produced no improvement. Histological examination showed an epidermotropic T-cell lymphoma with predominance of CD8- vs.CD4-positive lymphocytes. Based on the clinical picture and the histological findings, we diagnosed pagetoid reticulosis. Excision of the plaque and cream PUVA photo-chemotherapy produced long-term remission.
Asunto(s)
Micosis Fungoide/patología , Micosis Fungoide/terapia , Terapia PUVA , Adulto , Humanos , MasculinoAsunto(s)
Antiinflamatorios/uso terapéutico , Clofazimina/uso terapéutico , Necrobiosis Lipoidea/tratamiento farmacológico , Adulto , Betametasona/análogos & derivados , Betametasona/uso terapéutico , Femenino , Humanos , Inmunosupresores/uso terapéutico , Medias de Compresión , Tacrolimus/uso terapéuticoRESUMEN
Immunosuppressed patients are at increased risk of skin cancer. A 67-year-old renal transplant recipient developed a nodular malignant melanoma after 30 years of immunosuppression with azathioprine and prednisolone. The patient died of metastatic disease 3 months after the diagnosis was made. The function of the renal graft was not affected at all. Renal transplant recipients are at high risk of developing nonmelanocytic skin tumors when on immunosuppressive therapy with cyclosporine A. Less common is the development of skin cancer during immunosuppression with azathioprine. Latest reports show the increased incidence of malignant melanoma in immunosuppressed patients. Our case illustrates the necessity of close dermatological surveillance of allograft recipients, to assure an early recognition of any malignant skin tumor and to reduce the risk of systemic metastatic disease.