Ei. Mcburney et al., LUPUS ERYTHEMATOSUS-LIKE FEATURES IN PATIENTS WITH CUTANEOUS T-CELL LYMPHOMA, International journal of dermatology, 37(8), 1998, pp. 579-585
Background The development of lupus erythematosus-like (LE-like) featu
res in patients with cutaneous T-cell lymphoma (CTCL) has not been rep
orted previously in the literature. Both diseases, however, have been
etiologically linked to retroviruses. Objective Our purpose was to rep
ort four cases of patients with CTCL who developed LE-like features du
ring the course of their disease, and to evaluate for evidence of anti
bodies to retroviruses in the sera of these patients. Patients Four pa
tients with biopsy-proven CTCL with clinical or histologic features of
systemic lupus erythematosus (SLE) were evaluated for clinical and la
boratory criteria for SLE. Only one patient demonstrated four American
Rheumatism Association (ARA) criteria sufficient for the diagnosis of
SLE. The remaining three patients demonstrated one or two criteria fo
r SLE. In addition, the sera of these patients were examined by Wester
n blot analysis for evidence of human immunodeficiency virus type I (H
IV-I), human T-cell lymphotrophic virus type I (HTLV-I), or human intr
acistemal A-type particle type I (HIAP-I) retroviral proteins. Each pa
tient demonstrated antibodies to some of the retroviral proteins exami
ned. The sera of two patients reacted to proteins for HIAP-I, and the
sera of two patients reacted to p24 gag proteins of HIV-I. No patient
reacted to HTLV-I proteins. Conclusions Our report identifies four pat
ients with CTCL who developed LE-like features during the course of th
eir disease. Although the etiology of CTCL and SLE has not been well e
stablished, each has been linked to retroviruses. Evidence of antibodi
es to retroviral proteins was identified in each of our patients by We
stern blot analysis. Although the clinical and laboratory findings in
these cases do not resolve the etiologic role of retroviruses in CTCL
or SLE, they suggest that retroviruses may have a role in the pathogen
esis of the clinical phenomenon reported in these four patients.