[Ulceration of lymphomatous skin lesions in a patient with Sezary syndrome treated with brentuximab-vedotin]. / Ulcérations de lésions cutanées lymphomateuses sous brentuximab-védotin chez un patient atteint de syndrome de Sézary.

BACKGROUND: Brentuximab-vedotin (BV), an anti-CD30 agent combined with an anti-neoplastic agent, has recently yielded promising results in the treatment of cutaneous T-lymphomas such as Sezary syndrome. Surprisingly, these results are observed regardless of levels of CD30 expression by tumour cells. PATIENTS AND METHODS: Herein, we report the case of a 52-year-old man with Sézary syndrome (SS) with skin and lymph node involvement, and whose tumour cells were not expressing CD30 at the time of disease progression. His disease was refractory to several lines of treatment, and a partial response was obtained using BV therapy, with secondary ulceration of SS-specific skin lesions. DISCUSSION: Ulceration of our patient's skin lesions was concomitant with clinical improvement and the semiology was identical to cases of skin ulceration under methotrexate in patients with psoriasis or mycosis fungoides. The mechanism of action appears to be related to sudden interruption of the cell cycle in a context of rapid cell renewal, although the way in which the antibody acts on keratinocytes has not yet been fully elucidated.