Pigmented purpuric dermatitis revealing cutaneous lymphoma

Citation
D. Lipsker et al., Pigmented purpuric dermatitis revealing cutaneous lymphoma, ANN DER VEN, 126(4), 1999, pp. 321-326
Citations number
22
Language
FRANCESE
art.tipo
Article
Categorie Soggetti
Dermatology
Journal title
ANNALES DE DERMATOLOGIE ET DE VENEREOLOGIE
ISSN journal
0151-9638 → ACNP
Volume
126
Issue
4
Year of publication
1999
Pages
321 - 326
Database
ISI
SICI code
0151-9638(199904)126:4<321:PPDRCL>2.0.ZU;2-I
Abstract
Introduction. A few cases of patients with both purpuric pigmented dermatit is and cutaneous lymphoma have been reported. The aim of this study was to evaluate the prognosis of purpuric pigmented dermatitis. Material and methods. This is a monocentric retrospective study at the derm atology department of the university hospital of Strasbourg. The records of all patients hospitalized for purpuric pigmented dermatitis between 1967 a nd 1997 have been reviewed. Results. Eight women and 9 men aged between 17 and 84 years were hospitaliz ed for purpuric pigmented dermatitis during the reference period. Except fo r one patient, all had had a cutaneous biopsy showing the typical Features of purpuric pigmented dermatitis. On the basis of clinical signs and course , one patient was thought to have contact dermatitis and three patients wer e thought to have a purpuric pigmented dermatitis -like drug eruption (mepr obamate, pefloxacine and lorazepam or aspirin). The mean follow-up was one year. During follow-up, two patients developed cutaneous T-cell lymphoma af ter two and four years respectively and one patient developed Hodgkin's dis ease with skin and lymph node involvement. Another patient who suffered fro m purpuric pigmented dermatitis for four years had a monoclonal T cell popu lation within the dermal infiltrate. Two patients died of their lymphoma. Discussion. This study shows that purpuric pigmented dermatitis can be asso ciated to or evolve into lymphoproliferative disease. This course should be suspected when purpuric pigmented dermatitis is extensive, long-lasting (> 1 year), has a reticular arrangement and negative patch-testing, in this s ituation, a long-term follow-up and treatments indicated in the early patch stage of mycosis fungoides (PUVA therapy, chlormethine) seem adequate.