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February 1997

An Enlarging Papulosquamous Plaque on the Buttock

Author Affiliations

Hospital Clinic, Barcelona, Spain

Arch Dermatol. 1997;133(2):235-236. doi:10.1001/archderm.1997.03890380107019

REPORT OF A CASE  A 41-year-old white man presented with a pruritic plaque on his buttock that he had first noticed 1 month earlier. Physical examination revealed a 20×10-cm erythematous plaque that involved the posterior aspect of the left thigh and buttock (Figure 1). He had been diagnosed as having adult T-cell leukemia/lymphoma (ATLL) 2 years earlier, when he was evaluated for a casually detected lymphocytosis with 30% atypical circulating lymphocytes. Antibodies to the p24 protein of human T-cell lymphotropic virus type I (HTLV-I) and monoclonal integration of the viral DNA into the neoplastic lymphoid cells were both demonstrated at that time. Chemotherapy was initiated when the patient developed an increasing leukocytosis with symptomatic hypercalcemia. Nine months after his initial presentation, he achieved complete remission after being treated with combination chemotherapy consisting of 6 cycles of cyclophosphamide, doxorubicin (hydroxydaunomycin), vincristine sulfate (Oncovin), and prednisone (CHOP) and pentostatin (deoxycoformycin). He