BACKGROUND: Previous studies demonstrating that the neoplastic cells in Sézary syndrome and tumor stage mycosis fungoides express interleukin 4 (IL-4), IL-5, and IL-10 have resulted in the concept that cutaneous T-cell lymphomas are derived from CD4(+) T cells with a T(H)2 type cytokine profile. OBJECTIVE: To determine the cytokine profile in CD30(-) primary cutaneous large T-cell lymphomas, which represent a subgroup of cutaneous T-cell lymphoma with an aggressive clinical behavior (5-year survival rate of 15%). DESIGN AND METHODS: Seven biopsy specimens were taken from 4 patients with CD30(-) primary cutaneous large T-cell lymphomas and studied for the expression of T(H)1 (IL-2 and interferon gamma) and T(H)2 (IL-4, IL-5, IL-10) cytokines using a reverse transcription-polymerase chain reaction technique. Skin biopsy specimens from patients with Sézary syndrome, mycosis fungoides, atopic dermatitis, or psoriasis were included as controls. RESULTS: In the 7 CD30(-) primary cutaneous large T-cell lymphomas showing an almost pure population of large tumor cells (>90%), no expression of IL-4 was found, and IL-5 was only found in 1 of 7 cases. In control biopsy specimens, expression of IL-4 and/or IL-5 was demonstrated in atopic dermatitis (3/3), tumor stage mycosis fungoides (2/2), and Sézary syndrome (3/3), but not in plaque stage mycosis fungoides. CONCLUSION: Our results demonstrate that CD30(-) primary cutaneous large T-cell lymphomas do not produce T(H)2 cytokines, illustrating that not all cutaneous T-cell lymphomas have a T(H)2 cytokine profile.