Erythrodermic cutaneous T-cell lymphoma with disseminated pustulosis. Production of high levels of interleukin-8 by tumour cells

Interleukin (IL) -8 is a neutrophil chemoattractant cytokine with proinflam matory and growth-promoting activities, which is involved in the pathogenes is of several inflammatory diseases. It is found in high amounts in lesiona l biopsies of pustular diseases such as psoriasis and palmoplantar pustulos is. We report a 50-year-old woman with a 10-year history of erythroderma wi th disseminated pustulosis. Skin biopsies showed an epidermotropic infiltra te composed of atypical CD4+ CD8+ lymphocytes with numerous admixed neutrop hils. Peripheral blood flow cytometric analysis revealed a major clonal sub set of CD3+ CD4+ CD8+ T-cell receptor V beta 22+ atypical lymphocytes. Bone marrow biopsy, lymph node biopsy and computed thoracoabdominal tomography were normal. Serologies for human T-cell lymphotropic virus type I and huma n immunodeficiency virus were negative. Our patient's status deteriorated d espite topical (nitrogen mustard, psoralen plus ultraviolet A) and systemic (interferon, methotrexate, multiagent chemotherapy) treatments, and she fi nally died. We showed that our patient's peripheral blood lymphocytes (PBL) spontaneously produced high amounts of IL-8. In contrast, PBL of patients with classical Sezary syndrome produced lower amounts of IL-8. The producti on of IL-8 by tumour T cells could explain this unusual clinical and histop athological presentation of cutaneous T-cell lymphoma as disseminated pustu losis.