Leucoderma associated with flares of erythrodermic cutaneous T-cell lymphomas: four cases

We describe four patients with erythrodermic cutaneous T-cell lymphomas (tw o with erythrodermic mycosis fungoides, and two with Sezary syndrome) who p resented with extensive hypopigmented lesions that occurred during flares o f their cutaneous disease. These cases must be distinguished from previousl y described hypopigmented mycosis fungoides where hypopigmented lesions wer e the sole manifestation of the lymphoma. In two cases a biopsy was perform ed on hypopigmented skin, showing an infiltrate of atypical lymphocytes wit h epidermotropism and absence of melanocytes, as in vitiligo. It is suggest ed that the hypopigmentation could be due to the cytotoxicity of tumour or reactional lymphocytes directed against melanocytes.