A case of adult cell leukemia with generalized granuloma Trichophyticum.

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A 43-year-old man, born in Oita prefecture, noticed infiltrative erythemas 0.3-1cm in diameteron the back of his trunk, inguinal regionand thighs one year ago. He had no history ofblood transfusion. Laboratory examination revealed leukocytosis (WBC 36, 200/mm3, lymphocyte 20% includingatypical lymphocytes 57.5%), E rosette formation 88.5%, OKT3 28.5%, OKT4 91.0% andanti-ATLA antibody 160 times positive. Histopathologically, in the epidermis Pautrier's microabscessexisted and in the upper dermis or aroundthe vessels there were dense infiltrating tumorcells, many of which had highly atypical andhyperchromatic and convoluted nuclei. Based onthe above findings, a diagnosis of ATL wasmade. With a combination therapy of VEPAM, CVPand interferon, the disease was kept under goodcontrol for about eleven months. But in thecourse of the chemotherapy the skin lesions recurred. The patient was retreated with interferonwithout favorable response and he died ofrespiratory insufficiency. In the clinical course, generalized granulomatrichophyticum appeared on both thighs and theright elbow. Culture of the pus obtained fromthe granulomas yielded Trichophyton mentagrophytes.
日本皮膚科学会大阪地方会の論文