Gittler Julia, Martires Kathryn, Terushkin Vitaly, Brinster Nooshin, Ramsay David
Ronald O. Perelman Department of Dermatology, NYU School of Medicine, NYU Langone Medical Center.
Dermatol Online J. 2016 Dec 15;22(12):13030/qt14d1b851.
HTLV-1 is a virus that is endemic in southwesternJapan and the Caribbean and has been implicatedin the development of ATLL. ATLL, which is anuncommon malignant condition of peripheralT-lymphocytes, is characterized by four clinicalsubtypes, which include acute, lymphomatous,chronic, and smoldering types, that are based onLDH levels, calcium levels, and extent of organinvolvement. We present a 52-year- old woman withpruritic patches with scale on the buttocks and withtender, hyperpigmented macules and papules oftwo-years duration. Histopathologic examinationwas suggestive of mycosis fungoides, laboratoryresults showed HTLV-I and II, and the patient wasdiagnosed with primary cutaneous ATLL. We reviewthe literature on HTLV-1 and ATLL and specifically theprognosis of cutaneous ATLL. The literature suggeststhat a diagnosis of ATLL should be considered amongpatients of Caribbean origin or other endemicareas with skin lesions that suggest a cutaneousT-cell lymphoma, with clinicopathologic features ofmycosis fungoides. Differentiation between ATLLand cutaneous T-cell lymphoma is imperative as theyhave different prognoses and treatment approaches.
人类嗜T淋巴细胞病毒1型（HTLV-1）是一种在日本西南部和加勒比地区流行的病毒，与成人T细胞白血病淋巴瘤（ATLL）的发生有关。ATLL是一种外周T淋巴细胞的罕见恶性疾病，其特征有四种临床亚型，包括急性、淋巴瘤型、慢性和潜伏型，这些亚型是根据乳酸脱氢酶水平、钙水平和器官受累程度划分的。我们报告一名52岁女性，臀部有瘙痒性鳞屑斑块，伴有持续两年的压痛性色素沉着斑和丘疹。组织病理学检查提示蕈样肉芽肿，实验室结果显示HTLV-I和II阳性，该患者被诊断为原发性皮肤ATLL。我们回顾了关于HTLV-1和ATLL的文献，特别是皮肤ATLL的预后。文献表明，对于来自加勒比地区或其他流行地区、有提示皮肤T细胞淋巴瘤的皮肤病变且具有蕈样肉芽肿临床病理特征的患者，应考虑诊断为ATLL。区分ATLL和皮肤T细胞淋巴瘤至关重要，因为它们的预后和治疗方法不同。
