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Detection of circulating T cells with CD4+CD7- immunophenotype in patients with benign and malignant lymphoproliferative dermatoses.


J Am Acad Dermatol. 1996 Sep;35(3 Pt 1):404-10. Unique Identifier :

BACKGROUND: Cutaneous T-cell lymphomas (CTCLs) are malignancies of CD4+ T cells that involve the skin. CD4+CD7- cells may represent a malignant population in CTCL. OBJECTIVE: Our purpose was to compare the percentage of CD4+CD7- cells and the expression of pan-T-cell antigens in blood lymphocytes from 31 patients with benign dermatoses with 35 patients who had CTCL. METHODS: The patients with CTCL were classified as follows: 10 with mycosis fungoides (MF), seven with pre-Sezary syndrome (pre-SS), and 18 with Sezary syndrome (SS). Flow cytometry was used to determine the percentage of CD4+CD7- cells and the CD4/CD8 ratio and to detect aberrant expression of the pan-T-cell antigens CD2, CD3, and CD5. RESULTS: We found a mean of 5.8% CD4+CD7- cells for the 16 normal control subjects and 9.3% for the benign cases (p = 0.13). The patients with pre-SS and SS had a higher percentage of CD4+CD7- cells (22.4% and 35.5%, respectively) than patients with benign dermatoses (p < 0.01); no difference was found between patients with benign dermatoses and those with MF (p = 0.80). The mean CD4/CD8 ratio was 3.1 for the normal control subjects compared with 7.4 for the patients with benign dermatoses (p < 0.01). Patients with SS had a ratio of 49, which was higher than the ratio for those with benign dermatoses (p < 0.01); however, the ratio for patients with MF and pre-SS did not differ from that of the group with benign dermatoses (p = 0.71 and 0.55, respectively). Aberrant CD2, CD3, or CD5 expression was observed in 66% of patients with SS, 29% with pre-SS, 30% with MF, but in none of the patients with a benign dermatosis. CONCLUSION: Small numbers of CD4+CD7- cells can be found by flow cytometry in patients with a benign dermatosis and in normal control subjects. This T-cell subset is expanded in pre-SS and SS but not in MF. Aberrant pan-T-cell antigen expression is commonly observed in patients with SS but not in patients with a benign dermatosis.

Antigens, CD2/ANALYSIS Antigens, CD3/ANALYSIS Antigens, CD4/*ANALYSIS Antigens, CD5/ANALYSIS Antigens, CD7/*ANALYSIS Comparative Study CD4-CD8 Ratio Dermatitis, Atopic/BLOOD/IMMUNOLOGY Dermatitis, Contact/BLOOD/IMMUNOLOGY Dermatitis, Phototoxic/BLOOD/IMMUNOLOGY Flow Cytometry Human Immunophenotyping Lymphoma, T-Cell, Cutaneous/*BLOOD/IMMUNOLOGY Mycosis Fungoides/BLOOD/IMMUNOLOGY Neurodermatitis/BLOOD/IMMUNOLOGY Psoriasis/BLOOD/IMMUNOLOGY Sezary Syndrome/BLOOD/IMMUNOLOGY Skin/IMMUNOLOGY Skin Diseases/*BLOOD/IMMUNOLOGY Skin Neoplasms/*BLOOD/IMMUNOLOGY Support, Non-U.S. Gov't T-Lymphocyte Subsets/IMMUNOLOGY/*PATHOLOGY JOURNAL ARTICLE


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