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April 1992

Lymphoproliferative Nature of Granulomatous Slack Skin: Clonal Rearrangement of the T-cell Receptor ß-Gene

Author Affiliations

Department of Dermatology Faculty of Medicine University of Barcelona Casanova 143 08036 Barcelona, Spain

Arch Dermatol. 1992;128(4):562-563. doi:10.1001/archderm.1992.01680140146024

To the Editor.—  Granulomatous slack skin (GSS), an infrequent disorder characterized by progressively pendulous skin folds in flexural areas,1-4 has been considered autoimmune or inflammatory.2,3 Some cases have been associated with Hodgkin's disease.2 A histologic aspect similar to mycosis fungoides has been reported,1,5 which suggests that GSS could be a special variety of cutaneous T-cell lymphoma. Immunophenotype studies5 and clonal rearrangement of the T-cell β-receptor gene4 have shown the lymphoproliferative nature of this disease.

Report of a Case.—  In June 1989, a 66-year-old man presented with a submammary tumor that became enlarged during the previous 3 years. He had appreciable hyperpigmentation on the lumbosacral region and on the lower limbs. Later, a left supraclavicular nodule and night fever developed.The findings from the clinical examination revealed generalized poikiloderma and hyperpigmentation, a bulky fold under the left armpit, and pendulous indurated skin formations in the