Actinic reticuloid

We report two patients who satisfied the diagnostic criteria for actinic reticuloid (AR) on initial presentation, in whom genotypic analysis of early skin biopsies failed to show T-cell gene receptor rearrangements. Both patients progressed to widespread skin involvement associated with histopathological and genotypic features of mycosis fungoides (MF). Arguably, these patients may have had photosensitive MF from the outset, but their clinical features, phototesting, and subsequent demonstration of a T-cell gene receptor rearrangement in the skin could also suggest progression of AR to MF...

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Cutaneous pseudolymphoma refers to a heterogeneous group of benign reactive T- or B-cell lymphoproliferative processes of diverse causes that simulate cutaneous lymphomas clinically and/or histologically. The inflammatory infiltrate is bandlike, nodular, or diffuse and is composed predominantly of lymphocytes with or without other inflammatory cells. Depending on the predominant cell type in the infiltrate, cutaneous pseudolymphomas are divided into T- and B-cell pseudolymphomas. Cutaneous T-cell pseudolymphomas include idiopathic cutaneous T-cell pseudolymphoma, lymphomatoid drug reactions, lymphomatoid contact dermatitis, persistent nodular arthropod-bite reactions, nodular scabies, actinic reticuloid, and lymphomatoid papulosis...

AIMS: Differentiation between actinic reticuloid and cutaneous T cell lymphoma can be extremely difficult. Demonstration of clonal T cell receptor (TCR) gene rearrangements has been suggested as a potential diagnostic criterion, but the results obtained thus far have been conflicting. This study investigated whether TCR gamma gene rearrangement analysis, using polymerase chain reaction (PCR) in combination with denaturing gradient gel electrophoresis (DGGE) and immunohistochemistry, can serve as a diagnostic criterion...

Seven young patients with atopic dermatitis (AD) who presented with a marked photoexposed site dermatitis have been investigated in detail. The results of phototesting, patch testing and other investigations were compatible with the diagnosis of photosensitivity dermatitis/actinic reticuloid syndrome (PD/AR) (chronic actinic dermatitis). It is known that AD patients may have photoaggravation of their dermatitis or exacerbation secondary to a photodermatosis, such as polymorphic light eruption, actinic prurigo or drug-induced phototoxicity...

A 76 year old patient with actinic reticuloid was treated with Cyclosporin A. 11 months after beginning the immunosuppressive therapy, he developed lymphoedema and livid nodular skin lesions of the right leg, which histologically showed Kaposi's sarcoma. After stopping the Cyclosporin A and intralesional therapy with Interferon alpha, no regression of the Kaposi sarcoma could be seen. The characteristics of Kaposi sarcoma arising during immunosuppressive therapy and the differences in incidence, risk groups and distribution pattern compared to the classic sporadic and the AIDS-related Kaposi sarcoma will be described...

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BACKGROUND: Erythroderma may result from different causes. There have been no publications on this subject with special emphasis on survival. OBJECTIVE: The aim of the study was to determine the cause of the erythroderma and the prognosis of these patients. METHODS: Clinical and follow-up data from 102 patients with erythroderma were analyzed. We estimated survival of patients with erythroderma, from causes other than Sézary syndrome, mycosis fungoides, or leukemia cutis...

From 1989-1991, 214 patients (45 PD/AR, 54 PLE, 115 controls) were patch tested to a sunscreen series containing 9 constituents. 16/214 (7.5%) patients reacted to one or more sunscreens, with allergy being significantly more common in PD/AR patients (10/45 versus 2/54 PLE and 4/115 contact dermatitis clinic controls). The benzophenone group of sunscreens (mexenone, oxybenzone) were the most frequent sensitizers, accounting for 8 of the 27 positive patch tests observed. Clinicians should consider contact allergy to sunscreens in PD/AR patients as an explanation for exposed-site dermatitis episodes...

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Skin fibroblasts from certain patients with the photosensitivity dermatitis/actinic reticuloid syndrome show enhanced sensitivity to ultraviolet radiation compared to normal fibroblasts. To probe further the link between oxidative damage and this disease, we have obtained a more extensive set of cell lines from patients with a severe form of the disease and examined their sensitivity towards oxidative stress by measuring cell survival following UVA radiation (330-450 nm) or hydrogen peroxide treatment (0.1-2...

Abnormal photosensitivity of skin in the photosensitivity dermatitis/actinic reticuloid syndrome (PD/AR) correlating to an abnormal photosensitivity of dermal fibroblasts from these patients has been established previously. Cultured human skin fibroblasts from normal infant and adult donors, foreskin tissue and patients with PD/AR were assayed for oxidative stress induced membrane damage following ultraviolet A (UVA) radiation (340-450 nm) and hydrogen peroxide treatment by measurement of lactate dehydrogenase release...

In the management of photosensitivity dermatitis/actinic reticuloid syndrome (PD/AR) (syn. chronic actinic dermatitis), a chronic and often severe photodermatosis, there has been concern that patients may be predisposed to the development of lymphoreticular malignancy. A follow-up study of 231 patients with PD/AR who had been investigated at the Photobiology Unit, Ninewells Hospital, Dundee, between 1971 and 1991, was undertaken to determine (i) the incidence and type of malignancies (ii) the causes of any deaths...

Nine patients with photosensitivity dermatitis and actinic reticuloid syndrome are reported. The rash affected light-exposed skin only in 7 patients and extended to covered sites in 2. Seven were sensitive to UVB, UVA and visible light, one to UVA and one to visible light only. Two patients had significant clinical improvement in spite of both having suffered severe disease previously. Another patient remains exquisitely light-sensitive after 20 years and has developed two squamous cell carcinomas, one of which metastasized to local lymph nodes, and two keratoacanthomas on light-exposed skin...

BACKGROUND: As the differential diagnosis of erythrodermic actinic reticuloid vs Sézary syndrome (SS) can be very difficult, we examined the value of the nuclear contour index (NCI) on blood lymphocytes as the criterion for differential diagnoses. The NCI is defined as the nuclear parameter divided by the square root of the nuclear area. Three different parameters were studied: mean NCI, percentage of cells with an NCI of 6.5 or greater, and the highest NCI. These indexes were studied on blood lymphocyte samples obtained from 10 patients with erythrodermic actinic reticuloid and were compared with the findings in 10 patients with other benign forms of erythroderma and in seven patients suffering from SS...

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We report four cases of actinic reticuloid, including the first case ever reported in a woman. We have concluded that not all the patients are persistent light reactors and that the histologic presentation can be quite variable, in some cases extremely difficult to differentiate from a cutaneous lymphoma. Phototesting studies in incriminate the long UV and/or visible light range. The duration of the disease in these cases suggests a benign process which can be included among the cutaneous pseudomalignancies...

An elderly black man with photosensitivity suggestive of actinic reticuloid, ultimately developed Sézary syndrome, suggesting a relationship between the two conditions. This case illustrates a possible causal role of antigen persistence in the etiology of Sézary syndrome.

Instrumentation for studying action spectra in controls and various light-associated diseases is described. This study summarizes tests performed with a prism grating monochromator during the last 10 yr. There were 68 photodermatoses studied: xeroderma pigmentosum (XP) (1), lupus erythematosus (LE) (12), polymorphous light eruption (PLE) (23), solar urticaria (4), actinic reticuloid (2), halogenated salicylanilide photosensitivity and persistent light reactors (11), psoralen photosensitivity (6), and porphyria (9)...

Actinic reticuloid is a polymorphous dermatosis resulting from a photosensitivity to long wavelength ultraviolet light and occasionally also to visible light, often with clinical and histological resemblance to lymphoma. We describe a patient who is the second American case to be reported with this disease and review the literature. Actinic reticuloid must be distinguished from mycosis fungoides, polymorphous light eruption, persistent light reaction, and contact dermatitis.