Classification of Cutaneous Lymphomas-Reply

Abstract

We are grateful to Slater for his continued interest in the classification of the Dutch Cutaneous Lymphoma Group. The decision to include lymphomatoid papulosis (LyP) in the group of cutaneous T-cell lymphomas (CTCLs) is based on the histologic features of LyP suggesting a malignant lymphoma, the demonstration of clonality in approximately 50% of patients, the frequent association with other types of malignant lymphomas, and, above all, the many overlapping clinical, histologic, and immunophenotypic features between LyP and the primary cutaneous CD30-positive large T-cell lymphomas. 1 We agree with other investigators that these conditions constitute a spectrum of primary cutaneous CD30-positive lymphoproliferative disorders. 1,2 Current concepts on lymphomagenesis indicate that the development of a malignant lymphoma is a multistep phenomenon, in which accumulation of genetic alterations and an increasingly failing host response result in progression to more aggressive and ultimately fatal disease. In this concept, LyP might be considered