PRURIGO AS A CLINICAL PRODROME TO ADULT T-CELL LEUKAEMIA LYMPHOMA/

We report a case of adult T-cell leukaemia/lymphoma (ATLL) with prurig o as a prodromal skin manifestation. The patient was a 52-year-old wom an with a 2-year history of a fluctuating skin condition consisting of pruritic papules and pigmentation on her lower legs and right buttock . Prurigo was diagnosed at her first visit in October 1995, and she wa s found to be seropositive for human T-cell lymphotropic virus type 1 (HTLV-1). Two years later, the skin lesions had spread over the patien t's forearms and dorsa of the hands, and abnormal lymphoid cells had a ppeared in her peripheral blood. Southern blot analysis revealed monoc lonal integration of HTLV-1 provirus in the peripheral blood, but not in a skin lesion. Based on these results, a diagnosis of overt ATLL of the smouldering type was made. The findings in this case indicate tha t in healthy HTLV-1 seropositive carriers, prurigo requires careful fo llow-up as a cutaneous prodrome of ATLL.