Poligone et al described a rare form of cutaneous T-cell lymphoma that is localized to the skin of the lower leg. It is associated with an aggressive clinical course and poor prognosis. The authors are from the University of Rochester and Yale University.


Clinical features:

(1) A primary cutaneous lymphoma that arises in elderly adults (> 70 years).

(2) The involvement is localized to the lower extremities, primarily below the knees.

(3) The tumor may form plaques, tumors and/or ulcerations.

(4) The tumor shows a locally aggressive course.

(5) The tumor responds poorly to therapy with early relapse.

(6) Extracutaneous disease is absent or develops late.


A skin biopsy shows a dense infiltrate of atypical T cells that mark as helper cells (CD3+, CD4+, CD8-).


It is important to recognize this variant early so that aggressive management can be started.


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