Concurrent development of HIV-negative Kaposi’s sarcoma and mycosis fungoides in an elderly Inuit from Canada

Abstract

An 88-year-old Inuit man from Northern Canada presented with an extensive skin rash associated with numerous violaceous skin nodules on his palms and lower extremities. Biopsy of a skin nodule revealed Kaposi’s sarcoma (KS), a human herpesvirus 8 (HHV8)-associated malignancy, whereas biopsy of the erythematous skin showed an atypical infiltrate of CD4-positive T-cells that, together with TCR gene rearrangement and presence of clonal T-cells in peripheral blood by flow cytometry, was consistent with a T-cell lymphoma, mycosis fungoides (MF) subtype. Serology was negative for HIV and HTLV-I/II and no immunodeficiency syndrome was identified. The patient was successfully treated with an oral retinoid for KS, and with topical hydrocortisone and ultraviolet B (UVB) phototherapy for MF. This case highlights the existence of HHV8-related lesions in native persons of Northern Canada, and also that MF-induced immunosuppression combined with immunosenescence may play a role in the development of non-HIV-related KS.

Plasmacytic Pleural Effusion as a Major Presentation of Angioimmunoblastic T-Cell Lymphoma: A Case Report

“…The manifestations that can be observed in AITL include generalized lymphadenopathy, hepatomegaly, splenomegaly, systemic B symptoms, rash, polyarthritis, effusions and symptoms related to anemia [ 3 , 5 , 6 ]. The symptoms in the present case together with increased serum IgG may also resemble human herpesvirus 8 (HHV 8)-related conditions such as Kaposi sarcoma [ 29 , 30 ]. However, the serum HIV test was negative and the HHV-8 staining for the lymph node biopsy was negative.…”

Immunosenescence and Skin: A State of Art of Its Etiopathogenetic Role and Crucial Watershed for Systemic Implications

“…Concerning viral infections, the etiopathogenetic role of immunosenescence has been primarily established for herpes viruses. In this regard, beyond its etiologic role in the occurrence of Epstein-Barr virus (EBV)-positive mucocutaneous ulcers [163], it has recently been investigated the synergistic action between immunosenescence and mycosis fungoides-related immunosuppressive status in the onset of HIV seronegative Kaposi's sarcoma [164]. Moreover, immunosenescence itself would be enhanced by the action of cytomegalovirus, and both would synergistically be responsible for the reactivation of herpes simplex virus type 1 [165].…”