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

Abstract

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 studies 5 and clonal rearrangement of the T-cell β-receptor gene 4 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