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We evaluated the incidence, morphology, and immunophenotype of intraepidermal collections of mononuclear cells (ICMC) in a large number of inflammatory dermatosis and cutaneous lymphomas. ICMC appeared as small to large aggregates of cells, showing a morphology variable from monocytes to obvious dendritic cells, admixed with rare lymphocytes. ICMC were recognized in the epidermis or within hair follicle epithelium, and were either loosely or compactly arranged. ICMC were identified in 124 of 1,248 skin biopsies (9.9%) of inflammatory or lymphoid infiltrates, and were particularly frequent in spongiotic (43.4%) and in lichenoid dermatitis (10%), whereas they were rarely found in nonspecific superficial dermatitis (3.8%) and in psoriasis (4.7%). ICMC were also frequent in cutaneous T-cell lymphoma (13.3%), where they mimicked Pautrier abscesses. The ICMC forming cells showed a unique phenotype: the majority of them expressed CD1a and S-100, and lacked CD14, similar to mature Langerhans cells, but they were also strongly labeled by anti-CD11b, anti-CD36, and anti-CD68. Moreover, a subpopulation of them expressed CD83, an antigen that is usually absent on Langerhans cells. The occurrence of ICMC is a rather frequent, although hitherto poorly studied, phenomenon, occurring in several dermatosis, but particularly frequent in spongiosis-associated skin reactions. The cells within ICMC are represented by dendritic cells and dendritic cell precursors, whose phenotype indicates their derivation from circulating monocytes and differentiation into mature Langerhans cells.

A case of cutaneous T cell lymphoma associated with mild autoimmune disorders were also ruled out. A diagnosis of eosinophilia and rise of IgE levels is reported. A population of CTCL was made and treatment with IFN-␣ was started (9 MU CD3 ؊ CD4 ؉ cells was observed in the peripheral blood. After × 3/week), but was stopped 2 months later due to lack of comactivation, these purified CD3 ؊ CD4 ؉ cells showed a Th2 pattern pliance without clinical benefit. Psoralene plus UV-A (P-UVA) of cytokine production, secreting higher levels of IL-5 and ILtherapy induced complete regression of the mycosis fungoides years.Keywords: Th2 cytokines, cutaneous T cell lymphoma;In September 1995, in spite of a normal blood lymphocytecount (1620/ l), two-colour immunophenotypical studies revealed a small CD3 − CD4 + T cell population (Table 1). Rare lymphocytes with convoluted nuclei were observed in the Introduction peripheral blood smears. Eosinophil count was 842/ l and total IgE level 2888 KU/l. A new cutaneous biopsy demonOver the last few years, it has become clear that human T cells strated a dense dermal infiltration by CD4 + CD7 − cells in part can be divided into distinct subsets according to the pattern of lacking TCR␤ expression, whereas a bone marrow biopsy cytokine production: Th1 cells secrete mainly IL-2 and intershowed only moderate eosinophilia. feron-␥, whereas Th2-cells produce IL-4 and IL-5. 1 The enriched CD3 − CD4 + population, obtained by depletion Recently, it has been suggested that cutaneous T cell lymof CD3 + cells from PBMC using magnetic beads, as described phoma (CTCL) represents clonal proliferation of Th2-cells. 2 elsewhere, 4 showed defective response to mitogens activating Moreover, two cases of clonal expansion of CD3 − CD4 + T the cells through crosslinking of membrane receptors (PHA cells, without clinical evidence of lymphoma, secreting Th2-and CD3), but proliferative response, and expression of actitype cytokines have been recently described. 3,4 We report vation markers such as CD69 and CD25, was partially here a new case of CTCL associated with a population of circulating CD3 − CD4 + cells with a Th2-pattern of cytokine production.

Radiotherapy is feasible, safe and effective for localized PCLs. The choice of dose is related to histological subgroups and the related prognoses. Survival results are very good also in relapsing disease. In advanced cutaneous lymphoma radiotherapy alone has mainly a role in symptom palliation.

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