Regression of CD8+ pseudolymphoma after HIV antiviral triple therapy

Remission of Severe CD8+Cytotoxic T Cell Skin Infiltrative Disease in Human Immunodeficiency Virus–Infected Patients Receiving Highly Active Antiretroviral Therapy

“…This latter observation provided a rational basis for highly active antiretroviral therapy (HAART) as a first-line treatment in patients affected by this rare syndrome. However, prospective studies investigating the course of these skin symptoms during antiretroviral therapy have not been reported so far, and the remission of HIV-related CD8 + cutaneous pseudolymphoma following HAART has only been described in a single case [17]. In the present work, we report 8 cases of severe HIV-related CD8 T cell skin infiltrative disease following a favorable course of HAART, with evidence for a striking correlation between clinical remission and immune reconstitution and control of HIV replication.…”

“…Only a few cases of cutaneous T cell lymphomas (CTCL), including mycosis fungoides and Sézary syndrome, have been reported [2][3][4][5][6][7][8][9][10]. A CD8 cutaneous lymphoinfiltrative disease exhibiting some features of CTCL has been described in HIV-infected patients presenting with a severe erythroderma [11][12][13][14][15][16][17]. This entity has been denominated as pseudo-Sézary syndrome [11], CD8 cutaneous pseudolymphoma [18], or pigmented erythroderma [14], although some have adopted the more descriptive term atypical cutaneous lymphoproliferative disorder [16].…”

HIV-Related CD8+ Cutaneous Pseudolymphoma: Efficacy of Methotrexate

“…This hypothesis is supported by functional studies: CD8+ T cells derived from the lesional skin of HIV patients with CD8 infiltrative disease revealed both their belonging to the cytotoxic T cell lineage and their specificity towards HIV antigens [2]. Finally, the remission of skin symptoms with HAART, which parallels both the reduction of HIV-RNA load and the immune reconstitution of peripheral blood CD4+ lymphocytes, provides support for a causal relationship between HIV-induced immune deficiency and the CD8 expansion [3,4]. …”

“…HIV-related CD8+ cutaneous pseudolymphoma, first described in the late 1980s as a ‘pseudo-Sézary syndrome' with a CD8+ phenotype, is rare and usually occurs in patients with profoundly altered immunological and viral conditions [1,2,4,11,12,13,14]. …”

“…Usually, CD8+ cutaneous pseudolymphoma affects patients with a deep immunosuppression (CD4+ count <50/mm 3 ) and a positive HIV-RNA load, and it is rare in patients with mild immunosuppression [3]. In severely immunocompromised patients, highly active antiretroviral therapy (HAART) has showed its efficacy and is now considered as the first-line treatment [3,4]. In contrast, the therapeutic choice for moderately immunocompromised HIV-positive patients and/or patients already receiving HAART remains nonconsensual.…”