Kaposi's Varicelliform Eruption in Mycosis Fungoides

Vesiculobullous eruptions in mycosis fungoides (MF) are extremely rare. Here, we report a case of a 62-year-old woman presenting with erythematous patches and plaques of 2 years in duration, who had recently developed vesicles on erythematous MF plaques. Histopathological examination showed intra-subepidermal blisters, and infiltration of the epidermis by atypical lymphoid cells, forming Pautrier's microabscesses. Negative immunofluorescence excluded autoimmune blistering diseases. Immunohistochemistry revealed a CD4⁺ T-cell phenotype and gene rearrangement study confirmed a clonal T-cell proliferation. Kaposi's varicelliform eruption (KVE) developed in the patient 1 week after initiation of systemic corticosteroids and immunotherapy. Cluster of vesicles and erosions arising on the pre-existing plaque and a positive immunofluorescence test for Herpes simplex virus and histopathological examination confirmed the diagnosis of cutaneous herpes infection. This is the first case report on bullous MF complicated by KVE in the published work.

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“…HSV infection occurs commonly in MF patients. However, only a few MF patients with KVE have been reported …”

Section: Introductionmentioning

confidence: 64%

Bullous mycosis fungoides: Report of a case complicated by Kaposi's varicelliform eruption

Huang

Lin

et al. 2013

The Journal of Dermatology

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“…The ma¬ jor bacterial pathogen for cutaneous in¬ fections was Staphylococcus aureus, followed by ß-hemolytic streptococci. Aerobic gram-negative rods were present in 24 infections but were the sole pathogens in only six. Fifty-six bacterial skin infections were procedure-related: lymph node biopsy, 35 infections; lymphangiogram, seven infections; radiation therapy, six infections; surgical incision, four infections; intravenous catheter placement, two infections; and venous cutdown, two infections.…”

Section: Resultsmentioning

confidence: 97%

Infections Complicating Mycosis Fungoides and Sézary Syndrome

Axelrod

Lorber

Vonderheid

1992

JAMA

196

115

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Community-acquired bacterial skin infections are a common cause of morbidity in patients with mycosis fungoides and Sézary syndrome but are usually treated without hospital admission. Bacteremia and pneumonia, which are usually nosocomial, are the major infectious causes of death. Advanced disease stage, independent of corticosteroids and other therapies, is the most important risk factor for both cutaneous and systemic infections.

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“…Laboratory data MF, PUVA therapy, radiation therapy and antineoplastic agents, contributed to the development of KVE. [1][2][3][4] In our patient, KVE appeared during a combination of PUVA and SEBI therapies. It has been hypothesized that PUVA therapy could depress the CMI, 5 and radiation therapy could depress both the CMI and the NK cell activity.…”

Section: Discussionmentioning

confidence: 99%

“…However, only a few MF patients with Kaposi's varicelliform eruption (KVE) have been described. [1][2][3][4] We therefore report another patient, a Japanese female MF patient with KVE.…”

mentioning

confidence: 99%

Kaposi's varicelliform eruption in a patient with mycosis fungoides

Hayashi¹,

Yamada²,

Dekio³

et al. 1997

Clinical and Experimental Dermatology

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A 39-year-old Japanese woman suffering from plaque stage of mycosis fungoides (MF) developed Kaposi's varicelliform eruption (KVE) on her face. KVE appeared 1 month after commencing skin electron beam irradiation (SEBI), when the total irradiation had reached 46 Gy. Natural killer (NK) cell activity in the peripheral blood was abnormally low, but returned to normal after 1 year. However, lymphocyte reactivity to mitogens was persistently low. These facts suggested that the KVE in our patient developed because of abnormally low NK cell reactivity probably induced by radiation therapy.

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Kaposi's Varicelliform Eruption in Mycosis Fungoides

Cited by 24 publications

References 13 publications

Bullous mycosis fungoides: Report of a case complicated by Kaposi's varicelliform eruption

Bullous mycosis fungoides: Report of a case complicated by Kaposi's varicelliform eruption

Infections Complicating Mycosis Fungoides and Sézary Syndrome

Kaposi's varicelliform eruption in a patient with mycosis fungoides

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